- June 27, 2022
- Posted by: Mainframe Consulting
- Category: Business Wire
WASHINGTON–(BUSINESS WIRE)–Today the Medicare Advocacy Recovery Coalition (MARC) applauded Representatives Brad Schneider (D-IL) and Gus Bilirakis (R-FL) for introducing the Repair Abuses of MSP Payments Act (RAMP Act, H.R. 8063) in the U.S. House of Representatives. This bipartisan legislation advocates for significant changes to the Medicare Secondary Payer (MSP) system by repealing the outdated and unnecessary MSP “private cause of action” provision.
“This legislation is extremely important as it addresses a growing problem faced by far too many Americans, and our Coalition is grateful for the leadership of Representatives Schneider and Bilirakis,” said Gerardo Sanchez, Chair of MARC. “A significant component of the Medicare Secondary Payment provision is flawed, and an array of individuals and organizations across the country agree that the MSP ‘private cause of action’ should be repealed. The widespread support of the RAMP Act includes litigants, defendants, beneficiaries, and insurers,” noted Sanchez.
While the initial MSP laws were written to ensure Medicare doesn’t pay when another entity is responsible for paying a beneficiary’s claim, the purpose of “private cause of action” has been overtaken and rendered obsolete by changes in the law. Since 2007, the MSP statute ensures that every judgment, settlement, and award is reported to Medicare. Medicare then reports those to Medicare Advantage and Part D plans, and therefore there are no longer cases where only private parties are aware of primary plan non-payment. For those reasons, the “private cause of action” is no longer necessary.
Unfortunately, because of the current MSP “private cause of action,” if a Medicare beneficiary is injured and another entity is required to cover their healthcare expenses the impacted individual’s medical care and coverage could be negatively impacted for many years. Problems with this issue have been prevalent in a variety of situations including tort cases, auto insurance payments or workers’ compensation claims.
“Our Coalition generally advocates for MSP programs, but we also advocate against programs that don’t make sense for Medicare beneficiaries. We want the MSP program to work effectively, efficiently, and economically for all involved as Congress intended. It is with confidence that we share our support for the RAMP Act because it is a necessary step to ensure the MSP program is working to benefit all involved parties in a fair way. Sadly, the ‘private cause of action’ has been abused and interferes with Medicare beneficiaries’ ability to resolve claims, but the RAMP Act is the solution we’ve been waiting to see from Congress,” Sanchez concluded.
The Medicare Advocacy Recovery Coalition (MARC) is a national Coalition advocating for the improvement of the Medicare and Medicaid Secondary Payer (MSP) programs. The Coalition advocates for reforms to improve the MSP system and the process for Medicare beneficiaries and affected companies. MARC’s goal is to ensure that all stakeholders are provided timely resolution of disputes and the fair reimbursement of claims involving secondary payer issues.
Published at Mon, 27 Jun 2022 13:30:00 +0000