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The PAID Act and Its Consequences

by | Dec 11, 2020 | Medicare Advantage Plan Liens, Medicare Beneficiary Identification, Medicare Part-D Liens

What Is the PAID Act? 

On December 11, 2020, President Trump signed the PAID Act into law. Workers’ comp and liability insurers, self-insured entities, and several companies from the Medicare compliance industry have been lobbying Congress for this for several years. 

Here is what the PAID Act does: 

The Act requires CMS to provide the following additional information in its response to an RRE’s monthly Medicare query: 

  • Indicate whether a claimant is currently, or has been during the preceding 3-year period, entitled to benefits under a Medicare Advantage plan (Medicare Part C) or prescription drug plan (Medicare Part D); and, if so … 
  • Provide the name(s) and address(es) of those plans. 

The Act requires CMS to implement this on or before December 11, 2021. 

 

 

Reasons Why the PAID Act Is Needed 

The PAID Act resolves a few issues that have that have caused uncertainty in the industry about how Medicare Secondary Payer (“MSP”) law applies to Medicare Advantage plans (“MAPs”) and Medicare Part D prescription drug plans. Here, specifically, is what the law accomplishes: 

  • The Act eliminates ambiguity about whether MSP law applies to MAPs and Part D Drug Plans. 
  • The Act ensures that insurance carriers and self-insured organizations will have the data they need to obtain lien information from MAPs and Part D Drug Plans. 
  • The Act gives all parties to a claim the opportunity to eliminate post-settlement claims & lawsuits from MAPs and Part D Drug Plans. 

 

What the Passage of the PAID Act Means for Ringler Consultants 

Here are some implications that we see for Ringler consultants from the passage of the PAID Act: 

  • For any claim a Ringler consultant who provides services involving a claimant who is a Medicare beneficiary, you’ll need to be aware that there could be either a “regular” Medicare lien, a Medicare Advantage lien, or both! 
  • Insurance carriers and self-insured entities are, more and more, going to require that such liens be discovered and taken care of. 

How CP Resolutions Can Help 

CP Resolutions can handle Medicare, MAP and Part D liens. In fact, CP Resolutions only adds a small surcharge to handle the MAP and/or Part D lien … in addition to the regular Medicare lien. We make it as simple and cost-effective as possible for you to manage successfully all Medicare liens.