H&W: MSP Working Aged Provisions and Same-Sex Marriages

The Medicare Secondary Payer (MSP) Working Aged provisions generally require that Medicare be secondary payer to group health plans for individuals age 65 or over if their group health coverage is by virtue of the individual’s current employment status or the current employment status of the individual’s spouse.

CMS has announced that as a result of the Supreme Court’s Windsor decision, these provisions will apply to an individual who is a spouse by virtue of a same-sex marriage legally recognized by the jurisdiction in which the marriage was performed.

The expanded rules for the definition of “spouse” must be implemented with a start date for the coverage in question no later than January 1, 2015.

Same-sex spouses must also be included in MSP mandatory reporting. Although insurers or TPAs typically report this information, employers may be asked to assist in compiling information.