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Congressman Gus Bilirakis

Representing the 12th District of Florida


May 21, 2018
Press Release

Washington, DC:   Congressman Gus Bilirakis (R-FL) and Congressman Ron Kind (D-WI) have introduced bipartisan legislation (H.R. 5881) to strengthen Medicare and improve access for program participants.  This meaningful legislation closes important gaps in the Medicare secondary payer payment program with a simplified, commonsense approach. By amending the Medicare Secondary Payer (MSP) statute and clarifying its application to Medicare Advantage (MA), Medicare Part D, and Medicaid, the Provide Accurate Information Directly Act (PAID Act), provides beneficiaries who are parties to third-party settlements — such as in a tort case, workers compensation claim, or auto insurance payment — with improved access to the care for which they are entitled.

Whether they know it or not, each year hundreds of thousands of Medicare beneficiaries and companies across the country are hampered by outdated federal policies. The inability to obtain basic information about MSP liabilities hinders participants’ ability to retain access to proper care and quickly resolve medical liability settlements,” said Congressman Bilirakis. “This legislation will ensure that beneficiaries, Medicare, and Medicaid have a clear and quick way to identify whether or not a participant has an MSP obligation, and provide information about how that obligation can be resolved.  The PAID Act represents a ‘win-win-win’ for beneficiaries, plans, and the federal taxpayer,” he added.   

Congress can save significant money for taxpayers and drive a better coordination of benefits if it mandates the sharing of certain information between CMS and settling parties,” said Congressman Kind. “If settling parties are simply provided with basic plan information, they will be able to quickly repay liabilities associated with settlements, judgments, or awards.”

Congressmen Bilirakis and Kind have been working collaboratively for years to bring commonsense improvements to the arcane MSP statute. Their accomplishments extend back to 2012, when they co-sponsored the Strengthening Medicare and Repaying Taxpayer (SMART) Act — a key step in improving the MSP statute, which streamlined the process of settling claims and providing funds to Medicare beneficiaries. As Congressman Kind explained, “Since it became law in 2013, the SMART Act has drastically improved ‘secondary payer’ laws to provide greater fairness for beneficiaries who were trapped in a confusing maze of bureaucracy.”  Congressman Bilirakis added, “This new legislation, built to augment the SMART Act, will bring additional efficiencies to federal health care programs that will benefit beneficiaries, taxpayers, and employers.”

The MSP laws, enacted by Congress in 1980, have not kept up with the changes in the Medicare and Medicaid programs.  The enactment of the Medicare Advantage (Part C) program in 1996, the Medicare Prescription Drug (Part D) benefit in 2003, and changes to the Medicaid program over the past decades have changed the ways in which beneficiaries interact with the Medicare and Medicaid programs, and the potential secondary payer issues that may arise.  While the MSP statute has not kept up with these changes, the PAID Act will remedy this problem by bringing sensible reform to the law that will benefit Medicare Advantage and Part D Plans, Medicaid programs, Medicare beneficiaries, and those parties settling cases with them.