Anesthesia Coding Alert
Know How to Handle VA Insurance With Medicare
Question: One of our patients was originally covered by Medicare, but his main health insurance is now through the Veterans Administration (VA). Should we bill the VA as a Medicare Secondary Payer (MSP)? North Carolina Subscriber Answer: No, you cannot bill both the Centers for Medicare & Medicaid Services (CMS) and the VA for the same services — even if your patient is considered a beneficiary under both. Here’s why: The VA and Medicare are considered federal payment programs, and you cannot double dip so to speak. “If the beneficiary is entitled to both Medicare and Veterans Administration (VA) benefits, he or she may choose to receive treatment under either program,” explains Part B Medicare Administrative Contractor (MAC) Palmetto GBA in online guidance. “Federal statutes prohibit two payment programs from paying the same claim. This means if the VA pays, Medicare cannot pay,” adds Part B MAC WPS-GHA in its VA and MSP online guidance. “When the VA pays the claim, it is not a Medicare Secondary Payment (MSP) claim. The VA pays the claim in full. Medicare does not require you to submit a claim. You may submit a claim in case the VA takes the benefits back.” On Part A claims, if you have already billed Medicare as an MSP after billing the VA, you should cancel the claim ASAP, Part A MAC First Coast Service Options (FCSO) advises. “Cancel the original claim and submit the claim to the VA,” FCSO says in online guidance. “Once the canceled claim has processed, the Fiscal Intermediary Standard System (FISS) will automatically recoup the money you were paid.” If you have more in-depth VA and MSP questions, it’s a good idea to check with your specific MAC before submitting claims.
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