Commonsense reforms to the arcane MSP policy offer a simple and taxpayer-friendly solution to increase stakeholder certainty and remove barriers to care.
FOR IMMEDIATE RELEASE
Contact: Andrew Rosenberg (email@example.com), (202) 247-6301
The Medicare Advocacy Recovery Coalition (MARC) today lauded Rep. Gus Bilirakis (R-FL) and Ron Kind (D-WI) for their introduction of the Provide Accurate Information Directly Act (PAID Act) (H.R. 5881) – a bipartisan measure to improve the Medicare Secondary Payer (MSP) and Medicaid Third Party Liability (TPL) statute. While the MSP policy is designed to ensure that the Medicare and Medicaid programs do not reimburse healthcare expenses for which another entity is legally responsible, every stakeholder agrees that the process by which improper payments are recaptured is broken. The PAID Act will significantly improve the efficiency of the current system, providing a clear framework for communication among all stakeholders involved. MARC applauds Congressmen Bilirakis and Kind for their leadership in solving this important problem.
“The PAID Act will create a clear and functional MSP system for Medicare Advantage (MA), Medicare Part D, and Medicaid, benefitting beneficiaries and the programs alike,” said Margaret O’Connor-Fitzpatrick, Chair of the MARC Coalition and Senior Technical Administrator of MetLife Auto and Home. “Today’s complicated regulatory atmosphere leads to inappropriate coverage denials for beneficiaries; costly, but mandatory pursuit of miniscule recoveries; and a paralyzing uncertainty for parties to medical liability settlements. We thank Representatives Bilirakis and Murphy for their leadership and help to beneficiaries, the Medicare program, and entities resolving claims,” said Ms. O’Connor-Fitzpatrick.
“MARC applauds Congressmen Murphy and Kind for introducing the PAID Act,” said Mary Re Knack, Vice-Chair of MARC and an Attorney at Ogden Murphy Wallace PLLC. “Both Representative Bilirakis and Representative Kind have been true leaders in protecting Medicare beneficiaries and in leading the effort to improve the MSP program in a way that benefits all stakeholders. Following their leadership in 2012 when they sponsored the SMART Act and guided it through to enactment, we are delighted that these two Members of Congress are leading the effort again. We strongly encourage other lawmakers to follow their lead and to co-sponsor the PAID Act,” said Ms. Knack.
Currently, the process by which CMS recaptures payment for claims from MA Plans, Part D Plans, or Medicaid is broken. The result of this breakdown is that settling parties have no way to find out which MA Plan, Part D Plan, or Medicaid program the beneficiary is in, and therefore, cannot coordinate benefits or repay what is owed.
The PAID Act offers a commonsense solution to coordinating benefits between settling parties, Medicare Advantage Plans, Part D Prescription Drug Programs, and Medicaid Plans by requiring the one entity with this information, CMS, to disclose the information to the parties at the time of settlement. Though this disclosure, Congress can save the federal government significant money and drive a better coordination of benefits to repay MSP and TPL claims if it mandates the sharing of certain information between CMS and settling parties — specifically, whether the beneficiary is enrolled in MA, Part D, or the Medicaid program.
To achieve a more efficient solution for beneficiaries, taxpayers, and employers, MARC calls upon Congress to enact the Provide Accurate Information Directly Act (PAID ACT). Passage of the PAID Act will allow settling parties to repay MSP and TPL amounts, and allow for the coordination of benefits, by requiring CMS to share the needed information.
When a beneficiary is injured and another party is supposed to cover their healthcare expenses – such as in a workers compensation claim – Medicare’s legal responsibility to pay is “secondary.” Unfortunately, the current Medicare Secondary Payer (MSP) policy is convoluted and confusing, creating problems and inefficiencies for beneficiaries, settling parties and taxpayers alike. That’s why MARC exists: to support commonsense reforms to fix this broken system. MARC’s membership represents virtually every sector of the MSP regulated community including attorneys, brokers, insureds, insurers, trade associations, self-insureds and third-party administrators. For more information on MARC, please visit www.MARCcoalition.com.