Medicare as Secondary Payer

To the Editor.—  Recently, Dr Roper,¹ administrator of the Health Care Financing Administration (HCFA), outlined the current rules concerning when Medicare pays on a primary basis and when it considers itself as secondary payer.Among other points, he stated that "Medicare [is] the secondary payer for beneficiaries who are eligible through their entitlement to Social Security disability payments and who are also covered by a large group health plan through their own employment or that of a family member."At the same time, Kathleen A. Buto, acting director of the HCFA's Bureau of Eligibility, Reimbursement and Coverage, informed FMC Corporation that the HCFA has not yet been able to decide whether disabled former employees are covered under the Medicare secondary payer provision and that therefore "Medicare will pay conditional primary benefits on future claims, subject to possible recovery from the group health plan if it is decided that Medicare