PAID Act Signed Into Law

MARCH 1, 2021

Medicare Update - PAID Act Signed Into Law

Conditional payment resolution can be complicated when a Medicare Advantage Plan (Part C) and/or prescription drug (Part D) plan is involved in the equation.  These challenges include:

• Attorneys not conducting diligent discovery to uncover whether a Plan has paid for Medicare reimbursable expenses on behalf of an injured employee;

• The employee unable to identify the Plan they receive coverage from, or unwilling to cooperate; or

• Parties are only not having enough information.

These issues are compounded with the Coordination of Benefits (COB) Contractor cannot provide information due to legal roadblocks.  Passage of the PAID Act will resolve these challenges in the coming months.

Under the new law, the Contractor will be required to provide parties with Medicare Part C and D coverage information when an insurance carrier runs a conditional payment query.  According to Rafael Zeno of MSA Source, “Passage of the PAID Act is something we have been begging Congress to pass for a long time.  This new law creates a ‘win’ for everyone.”  Zeno continued, “We look forward to using new processes allowed for under the PAID Act to enhance the concierge experience for our partners in prompt and effective conditional payment investigation and resolution.”

The PAID becomes effective on December 11, 2021.  Until that time, MSA Source will continue to work closely with its partners and their defense counsel to ensure all conditional payments made are uncovered and resolved quickly.