While holding the for CMS (The Centers for Medicare and Medicaid Services) the complexity of the reimbursement of the Medicare Secondary Payer Act was recognized by a Federal Court:
"In re Avandia Mktg., 685 F.3d 353, 365 (3d Cir.2012); The Fourth Circuit has described the Medicare statute as “among the most completely impenetrable texts within human experience.” Rehab. Ass'n v. Kozlowski, 42 F.3d 1444, 1450 (4th Cir.1994). Other courts of appeal, including the District of Columbia Circuit, have echoed this assessment. See Abraham Lincoln Mem. Hosp. v. Sebelius, 698 F.3d 536, 540–41 (7th east Hosp. Corp. v. Sebelius, 657 F.3d 1, 13 (D.C. Cir.2011); Alhambra Hosp. v. Thompson, 259 F.3d 1071, 1076 (9th Cir.2001). For a more literary-flavored spin, consider Judge Lamberth's recent characterization of the statute as akin to “a law written by James Joyce and edited by E.E. Cummings.” Catholic Health Initiatives–Iowa, Corp. v. Sebelius, 841 F.Supp.2d 270, 271 (D.D.C.2012), rev'd, 718 F.3d 914 (D.C. Cir.2013).
Allina Health System v. Kathleen Sebelius, 982 F.Supp.2d 1 (DCT DC 2013)