Physician Notes: CMS Offers Tool to Determine When Medicare is Secondary

Why This Topic Matters

Understanding when Medicare pays first or second affects claim submission, coordination of benefits, and payment accuracy. The DME audit discussion highlights how documentation and supplier compliance issues can lead to overpayment findings and recovery actions.

Article Sections

1. CMS Medicare Secondary Payer Fact Sheet

   Introduces a CMS educational resource that summarizes common Medicare primary-versus-secondary payer situations. The section focuses on general coordination-of-benefits scenarios and where to find the fact sheet.

2. OIG report on DME modifier claims

   Summarizes an OIG report involving durable medical equipment claims and documentation review. The section discusses the broader audit findings, affected suppliers, and related compliance actions.