RAMP Act
- Bill Number
- H.R. 4056
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-06-20: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-02-27T19:11:37Z
AI-Generated Summary
Purpose
The "Repair Abuses of MSP Payments Act" (RAMP Act), H.R. 4056, aims to strengthen enforcement of Medicare's rules requiring certain health plans to pay medical claims before Medicare does (known as Medicare Secondary Payer or MSP provisions). It expands individuals' ability to sue group health plans that fail to make primary payments or provide proper reimbursements, helping to prevent Medicare from covering costs that should be paid by other insurers first.
Key Provisions
- Amends Section 1862(b)(3)(A) of the Social Security Act (which governs Medicare's payment rules).
- Specifies that individuals harmed by a group health plan's failure to pay primary or reimburse appropriately can file a private lawsuit for damages.
- Defines "group health plan" by reference to an existing part of the law (paragraph (1)(A)(v)), which typically includes employer-sponsored health insurance covering multiple people.
Significant Changes to Existing Law
- Replaces the term "primary plan" in the current law with "group health plan," making it clearer and more targeted that group health plans (like employer group insurance) can be directly sued under the private cause of action.
- This shifts from a broader or potentially ambiguous reference to "primary plans" (which could include various types of insurance) to explicitly focusing on group health plans, potentially broadening access to lawsuits for affected individuals.
Potential Impacts
- On Government Agencies: The Centers for Medicare & Medicaid Services (CMS) may see reduced improper payments from Medicare, as group health plans face stronger incentives (and legal risks) to pay claims first, potentially lowering federal healthcare spending.
- On Citizens: Medicare beneficiaries (often seniors or people with disabilities) could recover costs more easily through lawsuits, improving access to timely payments for medical bills and reducing out-of-pocket expenses.
- On International Relations: No direct impacts, as this is a domestic healthcare policy focused on U.S. insurance and Medicare systems.
- Overall, it could lead to more accountability for health plans but might increase legal disputes and administrative costs for insurers.
Main Stakeholders Affected
- Medicare Beneficiaries: Primary beneficiaries who can now more explicitly sue for unpaid claims.
- Group Health Plan Sponsors: Employers and organizations offering group health insurance, who may face increased litigation risks.
- Health Insurers: Companies administering group plans, potentially liable for damages if they fail to pay primary claims.
- Federal Government (CMS): Benefits from better enforcement of MSP rules to protect Medicare funds.
Notable Legal, Constitutional, or Political Implications
- Legal: Enhances the private right of action (a legal mechanism allowing individuals to sue directly in court rather than relying solely on government enforcement), which could lead to more court cases testing the boundaries of MSP liability. It does not alter core MSP obligations but clarifies who can be sued, potentially streamlining enforcement.
- Constitutional: No apparent challenges; it operates within Congress's authority to regulate interstate commerce and federal spending programs like Medicare.
- Political: Represents bipartisan support (introduced by Reps. Bilirakis and Schneider) to address perceived abuses in health plan payments, aligning with efforts to protect Medicare solvency amid rising healthcare costs. It may spark debate over increased litigation burdens on businesses versus protections for vulnerable populations.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Bilirakis, Gus M. [R-FL-12]
Cosponsors (1)
Rep. Schneider, Bradley Scott [D-IL-10]
Recent Actions
- 2025-06-20: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-06-20: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-06-20: Introduced in House
- 2025-06-20: Introduced in House
Bill Versions
- Repair Abuses of MSP Payments Act — issued 2025-06-20 — PDF (2 pages)