TPL5
Pay and Chase Identification
CMS-required outcome
For claims identified with a third-party liability and designated as 'mandatory pay and chase,' the system makes appropriate payments and identifies such claims for future recovery. (Examples include preventive pediatric services provided to children, or medical child support from an absent parent.)
Default metrics
- Percentage of claims identified as pay and chase.
- Percentage of recovered reimbursement for pay and chase claims.
Regulatory sources
- Section 1902(a)(25) of the Act
- 42 CFR 433.139(b)(3)(ii)