News & Insights

Cases & Deals

December 31, 2020

King & Spalding Advises on Landmark Medicare Reform Bills BENES Act and PAID Act, Both Passed By Congress

On December 21, 2020, Congress approved a significant modernization of Medicare’s enrollment provisions, updating the law for the first time since the national health insurance program was enacted in 1965. 

An important provision of the BENES Act (H.R. 2477) passed the Senate as part of the $900 billion pandemic aid package, which was signed this week by the president. The BENES Act (Beneficiary Enrollment Notification and Eligibility Simplification Act) will modernize Medicare enrollment by closing gaps in coverage due to late enrollment. The legislation was advanced by the Medicare Rights Center. More information about the bill is available on center’s website, here.

This follows another important reform to the Medicare Secondary Payer statute known as the PAID Act (H.R. 1375), which also passed the House three weeks ago and was signed into law shortly afterward. The PAID Act (Provide Accurate Information Directly Act) will improve the Medicare Secondary Payer program by allowing the Medicare program, insurers, large companies and Medicare beneficiaries to better coordinate benefits and ensure that parts of the Medicare program are timely repaid funds from settlements, judgements and awards. The bill was advanced by the MARC Coalition.

King & Spalding served as advisor to both the Medicare Rights Center and the MARC Coalition. The firm was involved in all aspects of bringing both pieces of legislation to Congress, including drafting the bills and engaging in congressional advocacy. The King & Spalding team was led by FDA and Life Sciences partner David Farber. The matter is significant as the BENES Act will help millions of Medicare beneficiaries receive the benefits they’re entitled to in a timely way -- tens of thousands of Americans who enrolled late into Medicare face outdated gaps in coverage which the BENES Act has now closed. Similarly, the PAID Act, by requiring that CMS shares information with settling parties, will close a harmful gap in the law and promote prompt resolution of Medicare Secondary Payer claims.