Bill Would Ensure Health Plans Pay Benefits for Medicare-eligible Workers

December 20, 2007 ( - Legislation approved by Congress this week contains a provision that would help ensure group plans, rather than Medicare, would pay health care bills for workers who continue to work past retirement age.

Business Insurance reports that under the provision the Department of Health and Human Services (HHS) would develop Medicare reporting requirements for employers and health plan administrators that would help regulators determine when an employer-sponsored plan should be the primary payer of workers’ health care bills. The department would also decide on how and at what frequency coverage information would have to be provided.

Measures passed during the 1980s made employer-sponsored plans the primary payer for employees who stay on the job after reaching age 65, and Medicare the secondary payer, Business Insurance pointed out.

The news report said government auditors have found that Medicare has paid hundreds of millions of dollars in claims that employer-sponsored plans should have covered, and HHS has sometimes had difficulty later recovering those amounts from the plans.