Health Plan Accountability: New Right to Sue for Failure to Pay First.
This law strengthens financial protection for citizens and the Medicare program. It creates a new private right to sue a group health plan (like employer-sponsored insurance) if it fails to meet its obligation to pay medical costs first. This makes it easier for individuals to recover damages caused when health plans attempt to shift costs onto Medicare or the beneficiary.
Key points
Individuals gain a new private cause of action to sue group health plans for damages.
This applies when a group health plan fails to act as the primary payer for medical services, violating Medicare Secondary Payer (MSP) rules.
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