We have previously blogged about the PAID Act- legislation promulgated by the Medicare Advocacy Recovery Coalition (MARC) which, if passed, would enable Responsible Reporting Entities (RREs) to have insight into Medicare Advantage Plan, Medicare Part D, and Medicaid enrollment information. This data would be provided in the query response file via MMSEA Section 111 Reporting. Franco Signor is proud to be a founding member of MARC and currently serving as members of the Executive Board of MARC. MARC was successful in passage of the SMART Act in 2012, and is continuing to bring initiatives such as the PAID Act to bring much needed reform to the Medicare Secondary Payer Act (MSP).
If you have been following our blog and recent MSP Medicare Advantage MSP private cause of action case law, you are aware that RREs/primary plans have been threatened nationwide with lawsuits by Medicare Advantage Plans alleging failure to reimburse Medicare Advantage Plan conditional payments, yet there is no central method for RREs/primary plans to inquire and obtain Medicare Advantage, Part D, or Medicaid enrollment information. The Centers for Medicare & Medicaid Services (CMS) has this information and provides it to Group Health Plans (GHPs), as such, the PAID Act’s simple request is that CMS also provide this information to Non-Group Health Plans (NGHPs) so that primary plans can be aware of plan enrollment and promptly reimburse these liens/conditional payments, where applicable. Knowing entitlement information would be helpful so that primary plans can avoid these double damages MSP private cause of action lawsuits.
We are pleased to share and thank Congressmen Bilkirakis and Kind, as well as the MARC Coalition for supporting and introducing PAID yesterday as HR 5881. A press release from the MARC Coalition can be found here.
We urge you to join MARC and support the PAID Act. To support the PAID Act and take action, click here. For questions on the PAID Act and more information about MARC membership, please contact us.