Medicare patients gain right to sue insurers for payment failures
H.R. 4056 — RAMP Act · Filed by Gus Bilirakis (R-FL) · 1 cosponsor · Introduced Jun 20, 2025 · Referred to committee
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What it does
This bill amends Medicare law to allow patients to sue their health insurance plans directly for damages when those plans fail to pay claims as the primary insurer or fail to reimburse Medicare appropriately. Currently, patients lack a private right to sue for such failures; this bill creates one.
Why we flagged it
The bill's operative mechanism is to create a private cause of action—a legal right to sue—for patients against health insurers. This is a procedural/remedial change that empowers individuals to enforce existing payment obligations through litigation.
What the text implies
- The bill does not specify the measure of damages (actual losses, statutory penalties, attorney fees, punitive damages), leaving that to existing law and judicial interpretation—the scope of recovery is unclear from this text alone.
- Litigation may increase administrative burden on insurers and potentially raise insurance premiums if defense costs and damage awards are passed to consumers.
- The amendment changes the liable party from 'primary plan' to 'group health plan'—the practical scope of this change depends on how those terms are defined in 42 U.S.C. § 1862(b)(1)(A)(v), which is not quoted here.
- Private litigation may create inconsistent enforcement across jurisdictions and reduce reliance on administrative remedies or regulatory oversight.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
Who it affects
Patients gain a direct legal remedy to recover damages when insurers improperly deny or delay primary payment or reimbursement to Medicare. This strengthens individual enforcement power against insurance companies and may deter payment failures, though the practical impact depends on litigation costs and the scope of damages recoverable under the amended statute.
Who stands to gain
- plaintiff attorneys (litigation fees)
- patients (damage awards, if successful)
Named in the bill
Medicare, Social Security Act, group health plans, health insurers, 42 U.S.C. § 1862(b)(3)(A)
Where it stands
1 cosponsor: 1 Democrats.
- Jun 20, 2025 — Introduced · Congress.gov: “Introduced in House”
- Jun 20, 2025 — Referred to House Committee on Energy and Commerce and House Committee on Ways and Means · Congress.gov: “Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a…”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Money around this bill
3 lobbying clients named this bill on 5 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $3,310,000 in lobbying spend. A filing names 22 bills on average, so that figure is what each filing reported, not a share belonging to this bill.
More lobbying clients named this bill than 61% of bills with at least one filing.
Gus Bilirakis, the sponsor, reported $937,250 in PAC receipts in the 2026 cycle.
- American Property Casualty Insurance Association — $2,140,000 on 1 filing
- Allstate Insurance Company — $1,050,000 on 2 filings
- Marc Coalition — $120,000 on 2 filings
Lobbying Disclosure Act filings through Jul 22, 2026. A filing shows who paid to lobby on a bill it names, not what changed.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (393 characters) on Aug 17, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
Money — Senate Lobbying Disclosure Act filings whose specific-issue field names this bill for quarters ending Dec 2025 to Jun 2026. A filing's amount is reported whole beside the median number of bills a filing names; it is never divided across them. PAC receipts are FEC-reported contributions to the sponsor's candidate committee in the 2026 cycle.
As of — lobbying records through Jul 22, 2026 · page rendered 2026-10-20.
“Medicare patients gain right to sue insurers for payment failures” QuorumCivic. https://share.quorumcivic.app/bill/119/hr4056 Report an error
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