The PAID Act and Its Impact on Medicare Secondary Payor Reporting

The Provide Accurate Information Directly (“PAID”) Act was signed into law on December 11, 2020, as part of H.R. 8900, which extended the government’s fiscal deadlines. Title III of the PAID Act requires the Centers for Medicare & Medicaid Services (CMS) to increase its process in identifying whether a claimant is currently entitled to, or during the preceding 3-year period has been entitled to, Medicare Part C and/or Medicare Part D.

Previously, when a Section 111 Query was made, CMS would only confirm if the claimant was enrolled in Medicare. It did not provide any information regarding the type of Medicare program. Under the PAID Act, insurers can identify if the claimant is currently entitled to, or in the previous three years have been entitled to, Medicare and if the program is a Medicare Advantage Plan or Part D prescription program. This will allow insurers to properly identify applicable plans and issue primary payment or reimbursement of qualifying payments.

The Act was created as a result of lawsuits filed by Medicare Advantage Plans asserting recovery rights against insurers for double recovery, for failure to provide primary payment or reimbursement for qualifying charges.[2] The PAID Act will allow insurers t CMS must implement the PAID Act by December 11, 2021. CMS must implement the PAID Act by December 11, 2021.o better identify the claimant’s Medicare plans and avoid unnecessary litigation.

CMS must implement the PAID Act by December 11, 2021.

Source: https://www.jdsupra.com/legalnews/the-paid-act-and-its-impact-on-medicare-72976/