Vol. 16, No. 13
September 20, 1999
Medicare Data Match Project Forms Attached
In the past, the Department of Employe Trust Funds (ETF) has, through
the Employer Bulletin, provided the Part II forms
(included) of the Medicare Data Match Project to state
agencies and local governments participating in the health insurance
program. The enclosed forms pertain to group health insurance plans
offered since January 1, 1997.
The Medicare Data Match Project is a federal program that requires
employers and health care plans to provide information about specific
former employes covered under the employer health plan. Medicare,
administered by the Health Care Financing Administration (HCFA),
may ask you questions regarding these employes.
If Medicare asks you for information, you'll find
instructions on how to respond in the Medicare mailing.
Medicare may contact employers for specific dates of employment
and health care plans selected by the employe. The data match enables
Medicare to determine if former employes were eligible for the employer's
group health plan as a primary carrier. In some cases, Medicare
finds it has paid benefits as the primary carrier prior to payment
by the employer's plan. By cross-checking dates of coverage
and employment, Medicare may pursue recovering some of these benefits.
Following this Bulletin is a link to the completed Part
II of the Data Match Form which provides a complete list
of plans for employers to use in a Medicare inquiry. It is in a
PDF format. You must have Adobe Acrobat to view these files. The
completed Part II forms may be photocopied and submitted to Medicare
along with other Parts completed by the employer.
Please note: Employers are required to list only
the plans that identify employes for that plan. If a small number
of employes and plans are involved, employers may wish to do their
own list rather than use the ETF list. In addition, the self-insured
plans listed on line 25 (Standard, Standard II and SMP) have different
"Type of GHP" code letters. State employers are
D and local employers are E.
ETF has no specific role in coordinating this effort. Direct your
questions concerning the data match directly to Medicare. If you
receive a Medicare Data Match inquiry and have questions, contact
the Medicare Toll Match Project toll free at (800) 999-1118.
Completed Part II of the Data Match Form (updated 11/08/2002)