[Congressional Record Volume 166, Number 214 (Thursday, December 17, 2020)]
[Extensions of Remarks]
[Page E1167]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]





  SUPPORTING H.R. 1375, THE PROVIDE ACCURATE INFORMATION DIRECTLY ACT

                                 ______
                                 

                         HON. GUS M. BILIRAKIS

                               of florida

                    in the house of representatives

                      Thursday, December 17, 2020

  Mr. BILIRAKIS. Madam Speaker, I rise today in support of H.R. 1375, 
the Provide Accurate Information Directly (or PAID) Act which includes 
an important provision amending the Medicare Secondary Payer Act. That 
provision facilitates expanded communication between the Medicare 
program and insurers and self-insured entities settling liability, no-
fault, and workers' compensation claims with Medicare beneficiaries who 
may be covered by a Medicare Advantage (Part C) Plan or Medicare 
Prescription Drug (Part D) Plan. This is important for Medicare 
beneficiaries, who today resolve claims around a car crash or a slip 
and fall, but because of the way the law works can later be sued by a 
Medicare Advantage Plan for repayment. It has happened before--the PAID 
Act will fix that problem and allow beneficiaries to sleep at night 
knowing that they have fully resolved their claims.
  Congress amended the MSP statute in 2007 through Section 111 of the 
MMSEA to require parties to a dispute (known as ``Primary Plans'') to 
report settlements, judgments and awards to Medicare, called ``Section 
111 Reports.'' That allowed Medicare to seek recovery from settling 
parties under the Act when Medicare paid for health care because other 
payment was not available or reasonably expected to be available. While 
that program has been successful for the Medicare fee-for-service 
program, where the Center for Medicare and Medicaid Services (CMS) has 
the claims data for recovery, it has not been as successful for the 
Part C and Part D programs, where CMS does not have the Part C and Part 
D claims data and cannot recover for payments that have been made. To 
compound the problem, settling parties are often unable to identify the 
correct Part C or Part D plan to be able to coordinate benefits should 
they choose to do so. The PAID Act closes that critical information 
gap, by having CMS communicate the Part C and Part D plan 
identification to settling parties in response to a Section 111 Report. 
CMS has that data and can provide it.
  Congress is aware that for the last eight years CMS has provided all 
Section 111 Reports to the Part C and Part D Plans, and Congress 
expects that CMS will continue to do so after this legislation is 
enacted. Further, the existing MSP statute and regulations impose 
specific requirements on CMS, and on Part C and Part D Plans, to pay 
for claims in some situations, to not pay for claims in other 
situations, and to pursue recovery of claims when appropriate. Nothing 
in this legislation is intended to change any of those obligations or 
requirements, and Congress expects Part C and Part D Plans to continue 
to seek recovery of claims by timely notifying settling parties when a 
payment has been made that should be reimbursed, consistent with the 
CMS notice procedures. This legislation is only intended to provide 
more information to the settling parties, so that they have the ability 
to coordinate with Part C and Part D Plans earlier if they so choose.
  Congress has afforded CMS 18 months to implement this law and urges 
CMS to move with all deliberate speed to both implement its own system 
changes and coordinate with all Primary Plans throughout the 
implementation process. Regular communication and coordination will be 
critical to ensuring that Primary Plans are aware of the data exchange 
requirements that CMS plans to implement, and to ensure that Primary 
Plans are prepared as quickly as possible to utilize the data CMS will 
be providing under this law. By involving all stakeholders throughout 
the implementation process, CMS can implement our intention that the 
needed Plan identity information be available for parties to coordinate 
benefits as quickly as possible.
  I urge my colleagues to support this fix.

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