Coordination of Benefits and Third Party Liability (COB/TPL) in Medicaid (COB/TPL) 2016

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the release of important information for states on Medicaid Coordination of Benefits with third parties.  Today we issued Coordination of Benefits and Third Party Liability (COB/TPL) in Medicaid 2016, a Handbook that provides guidance on many COB/TPL subjects.  The Handbook also contains five training presentations on major COB/TPL topics.   

The Handbook includes a COB/TPL overview, core concepts such as payer of last resort status and assignment of rights to third party payments, Medicaid state plan requirements, ways to identify third parties, claims payment methodologies, COB for Medicaid beneficiaries with Medicare coverage, COB and Medicaid managed care, and recovery from casualty/tort settlements and from the estates of deceased Medicaid beneficiaries.  This guidance will be updated as necessary. 

The Handbook may be accessed at:  https://www.medicaid.mgov/medicaid/eligibility/tpl-cob/index.html.

Questions about the Handbook may be directed to any member of the COB/TPL Team: 

                Cathy Sturgill, 410-786-3345, cathy.sturgill@cms.hhs.gov

                Ginger Boscas, 410-786-3098, ginger.boscas@cms.hhs.gov

                Sara Rhoades, 410-786-4484, sara.rhoades@cms.hhs.gov