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Medicaid Update: Transmittal #13-14 DC Medicaid Recovery Process when Medicare is the Primary Payer

Thursday, August 15, 2013

Federal regulations found at 42 CFR 433.139 require that DHCF recover payments when a liable third party such as Medicare is identified. Beginning October 1, 2013, DHCF will begin recovery activities for claims paid by Medicaid that were eligible for Medicare coverage on the dates of service. Xerox, on behalf of DHCF, intends to initiate the recovery of funds for claims paid by DC Medicaid that should have been billed to Medicare as the primary payer.