Which law outlines when Medicare is considered the primary payer?

The correct answer is the Consolidated Omnibus Budget Reconciliation Act (COBRA), as it addresses certain situations in which Medicare is designated as the primary payer. COBRA primarily relates to health insurance coverage continuation for employees and their dependents after losing job-based coverage. However, it also includes provisions that identify how Medicare fits into the broader scope of health insurance and its coordination with other payers.

Understanding COBRA is crucial because it delineates how Medicare interacts with other types of health coverage when individuals become eligible for Medicare. For instance, when an individual has both employer-sponsored health insurance and Medicare, COBRA provisions may influence whether Medicare or the employer's insurance pays first.

The Affordable Care Act (ACA), while transformative for healthcare in many aspects, mainly focuses on expanding health insurance coverage and does not specifically outline the primary payer status of Medicare. The Medicare Modernization Act primarily introduced changes related to Medicare prescription drug benefits but doesn't directly define primary payer rules. The Health Insurance Portability and Accountability Act (HIPAA) focuses on protecting patient data and privacy and does not address Medicare's role as a primary payer.

By focusing on the provisions introduced by COBRA, one can better understand the scenarios in which Medicare serves as the primary payer and the implications for