MSA News - Medicare Secondary Payer (MSP) Rules for Same Sex Spouse Under MMSEA Reporting for Group Health Plans (GHP)

Medicare Secondary Payer (MSP) Rules for Same Sex Spouse Under MMSEA Reporting for Group Health Plans (GHP).

As background for its ruling, Section 3 of the Defense of Marriage Act (DOMA) provided that for purposes of federal law, the term “spouse” could not include individuals in a same-sex marriage. Because the MSP Working Aged provisions only apply to subscribers and their spouses, the Working Aged provisions did not apply on the basis of spousal status to individuals in a same-sex marriage. The United States Supreme Court has now invalidated this DOMA provision. Consequently, CMS is no longer prohibited from applying the MSP Working Aged provision to individuals in a same-sex marriage. The Department of Health & Human Services has therefore adopted a policy treating same-sex marriages on the same terms as opposite-sex marriages to the greatest extent reasonably possible. Any same-sex marriage legally entered into in a U.S. jurisdiction that recognizes the marriage - including one of the 50 states, the District of Columbia, or a U.S. territory -- or a foreign country, so long as that marriage would also be recognized by a U.S. jurisdiction, will be recognized. Consistent with this policy and the purpose of the MSP provisions, effective January 1, 2015, the rules below apply with respect to the term “spouse” under the MSP Working Aged provisions. This is true for both opposite-sex and same-sex marriages as described herein. For more information, please click here.