Historically, Medicaid has been considered by CMS as the "payer of last resort."
As recently as April, 2003, CMS sent a State Medicaid Directors Letter (SMDL #03-004) to the Medicaid Directors and it states that Medicaid is required to "cost avoid" claims and reject those claims which may be billed to a third party. This includes when Medicaid learns of the existence of such a party after the claim has been paid, or a third party becomes available after the claim has been paid. Medicaid must seek recovery from any third party. The memo states that "when the third party is Medicare, neither the Medicare nor Medicaid statute, nor HHS's regulations or policies prohibit any state from recouping its Medicaid payment from providers" (emphasis added). This can be found at CMS website, http://www.cms.hhs.gov/states/letters/smd040803.pdf Lita D. Atkinson ------------ In a message dated 12/23/2003 12:36:56 PM Eastern Standard Time, [EMAIL PROTECTED] writes: > > Subj: can a MCD resident waive MCR? > Date: 12/23/2003 12:36:56 PM Eastern Standard Time > From: "Jamie Morris, RN" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Reply-To: [EMAIL PROTECTED] > Sent from the Internet (Details) > > > If a resident is MCD and tube fed, can the family choose to waive MCR and have the > resident be MCD? Or is this only an > option for private pay residents? > http://www.cms.hhs.gov/states/letters/smd040803.pdf /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
