Repair Abuses of MSP Payments (RAMP) Act
- Bill Number
- S. 3816
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-02-10: Read twice and referred to the Committee on Finance.
- Last Updated
- 2026-03-30T20:17:07Z
AI-Generated Summary
Purpose
The Repair Abuses of MSP Payments (RAMP) Act aims to strengthen enforcement of Medicare Secondary Payer (MSP) rules by allowing individuals to sue group health plans directly for damages if those plans fail to make primary payments (paying first before Medicare) or provide proper reimbursements. MSP rules require certain private insurances, like group health plans, to cover costs before Medicare steps in as the secondary payer.
Key Provisions
- Amendment to the Social Security Act: The bill modifies Section 1862(b)(3)(A) of the Social Security Act (which governs Medicare's conditions for payment).
- Private Cause of Action: It explicitly permits lawsuits for damages against a "group health plan" (defined as employer-sponsored health insurance covering employees and dependents) if the plan does not fulfill its primary payment obligations or reimburse appropriately.
- Short Title: The legislation is titled the "Repair Abuses of MSP Payments (RAMP) Act."
Significant Changes to Existing Law
- Under current law, private lawsuits for MSP violations target "primary plans" broadly, which include various types of insurance.
- This bill narrows and specifies the language to focus on "group health plans," making it clearer that these plans can be held liable through private actions. This change replaces the term "primary plan" in the relevant statute, potentially simplifying enforcement by directly naming group health plans as targets for such suits.
Potential Impacts
- On Government Agencies: The Centers for Medicare & Medicaid Services (CMS) may see reduced administrative burdens in recovering improper payments, as private lawsuits could shift more recovery efforts to individuals or attorneys, potentially increasing overall reimbursements to Medicare.
- On Citizens: Beneficiaries (e.g., Medicare enrollees with group health coverage) gain a direct legal tool to seek damages for delayed or denied primary payments, which could lead to faster access to care and financial relief from out-of-pocket costs.
- On International Relations: No direct impacts, as the bill focuses on domestic U.S. health insurance and Medicare systems.
Main Stakeholders Affected
- Medicare Beneficiaries: Primary beneficiaries who can now more easily pursue private lawsuits against their group health plans.
- Group Health Plans and Insurers: Employers and insurance providers offering group coverage may face increased litigation risk and costs for non-compliance with MSP rules.
- Healthcare Providers: Could benefit indirectly through quicker payments from primary plans, reducing billing delays.
- U.S. Government (via Medicare): Gains potential for better protection of federal funds without always needing to intervene directly.
Notable Legal, Constitutional, or Political Implications
- Legal Implications: Enhances private enforcement of federal MSP laws, potentially increasing court cases and clarifying liability for group health plans. This could set precedents for interpreting "primary payer" responsibilities but might raise questions about the scope of damages recoverable in such suits.
- Constitutional Implications: None apparent; the bill aligns with Congress's authority to regulate interstate commerce and federal spending programs like Medicare.
- Political Implications: Introduced by bipartisan senators (Scott of South Carolina and Hassan of New Hampshire), it addresses perceived abuses in health insurance payments, appealing to efforts to protect taxpayer-funded Medicare while holding private insurers accountable. Referral to the Senate Finance Committee suggests focus on fiscal and health policy debates.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (1)
Sen. Hassan, Margaret Wood [D-NH]
Recent Actions
- 2026-02-10: Read twice and referred to the Committee on Finance.
- 2026-02-10: Introduced in Senate
Bill Versions
- Repair Abuses of MSP Payments (RAMP) Act — issued 2026-02-10 — PDF (2 pages)