To amend title XVIII of the Social Security Act to permit a private cause of action for damages in the case of a group health plan which fails to provide for primary payment or appropriate reimbursement.
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IntroducedMr. Bilirakis (for himself and Mr. Schneider) introduced the following …
Summary
What This Bill Does
The RAMP Act (Repair Abuses of MSP Payments Act) changes Medicare Secondary Payer rules to narrow who can be sued for failing to pay medical bills before Medicare does. Currently, Medicare beneficiaries can file private lawsuits against any "primary plan" that should have paid first - including auto insurers, workers compensation carriers, and other liability insurers. This bill limits those lawsuits to only employer-sponsored group health plans.
Who Benefits and How
Auto insurance companies, workers compensation insurers, liability insurers, and no-fault insurance providers benefit significantly. Under current law, they can be sued by Medicare beneficiaries if they fail to pay medical claims before Medicare. This bill shields them from those private lawsuits entirely, reducing their legal risk and litigation costs. Defense attorneys who represent these insurers in Medicare Secondary Payer cases will also see reduced revenue opportunities as these lawsuits disappear.
Who Bears the Burden and How
Medicare beneficiaries lose the right to sue non-group-health-plan insurers (like their auto insurance or workers comp) for failing to pay medical bills before Medicare. Plaintiffs attorneys who specialize in Medicare Secondary Payer litigation will see fewer cases and reduced revenue. The Medicare Trust Fund may receive less reimbursement from non-group-health-plan sources, potentially shifting costs to taxpayers. Group health plans remain subject to lawsuits with no change to their current liability.
Key Provisions
• Amends Section 1862(b)(3)(A) of the Social Security Act to replace "primary plan" with "group health plan" in the private cause of action provision
• Exempts auto insurance companies from private Medicare Secondary Payer lawsuits
• Exempts workers compensation insurers from private Medicare Secondary Payer lawsuits
• Exempts liability and no-fault insurers from private Medicare Secondary Payer lawsuits
• Maintains existing lawsuit rights only against employer-sponsored group health plans
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
Amends Medicare Secondary Payer rules to narrow private cause of action to only group health plans, excluding other types of primary payers like auto insurance or workers compensation
Policy Domains
Legislative Strategy
"Narrow the scope of private lawsuits under Medicare Secondary Payer rules to reduce litigation exposure for non-group-health-plan entities"
Likely Beneficiaries
- Auto insurance companies (no longer subject to private MSP lawsuits)
- Workers compensation insurers (no longer subject to private MSP lawsuits)
- Liability insurers (no longer subject to private MSP lawsuits)
- No-fault insurance providers (no longer subject to private MSP lawsuits)
- Defense attorneys representing these entities
Likely Burden Bearers
- Medicare beneficiaries (lose ability to sue non-group-health-plan primary payers)
- Plaintiffs attorneys specializing in MSP litigation
- Medicare Trust Fund (may receive less reimbursement from non-group-health-plan sources)
- Taxpayers (if Medicare recovery decreases, costs shift to taxpayers)
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "cms"
- → Centers for Medicare & Medicaid Services (administers Medicare program)
- "group_health_plans"
- → Employer-sponsored health insurance plans as defined in Medicare Secondary Payer statute
- "medicare_beneficiaries"
- → Individuals entitled to Medicare who may have group health coverage
Note: No scope conflicts - this is a single-section amendment to existing law
Key Definitions
Terms defined in this bill
As defined in Section 1862(b)(1)(A)(v) of the Social Security Act - typically employer-sponsored health plans that must pay primary to Medicare
Broader term that includes any plan that is required to pay before Medicare (auto insurance, workers comp, group health plans, etc.)
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology