Fed Regist. 1983 Apr 5;48(66):14802-12.
These regulations set forth policies and procedures on coverage of services that are reimbursable under automobile medical, no-fault, or liability insurance, and services to end-stage renal disease (ESRD) beneficiaries who are also covered under employee group health plans. The regulations are necessary to implement section 953 of the Omnibus Reconciliation Act of 1980 and section 2146 of the Omnibus Budget Reconciliation Act of 1981. The first of these sections excludes from Medicare coverage any services for which payment has been made or can reasonably be expected to be made under an automobile or liability insurance policy or plan or under no-fault insurance. The second section makes Medicare benefits secondary to benefits payable under an employer group health plan for services furnished to ESRD beneficiaries during a specified period of up to 12 months. The intent is to conserve Medicare funds and prevent duplicate payments by Medicare.
这些规定阐述了有关汽车医疗保险、无过失保险或责任保险可报销服务的覆盖范围的政策和程序，以及针对同时参加员工团体健康计划的终末期肾病（ESRD）受益人的服务。这些规定对于实施1980年《综合预算协调法案》第953条和1981年《综合预算协调法案》第2146条是必要的。其中第一条规定，对于已根据汽车或责任保险单或计划或无过失保险支付或可合理预期支付的任何服务，医疗保险不予覆盖。第二条规定，在长达12个月的特定期间内，对于提供给ESRD受益人的服务，医疗保险福利为雇主团体健康计划应支付福利的次要福利。目的是节省医疗保险资金并防止医疗保险重复支付。
