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Wednesday, July 31, 2013

Liability Claim Collateral Source Payments Subject to MSP

Medicare is not required to abide by a stipulated order of allocation of benefits in a liability case when seeking reimbursement under the Medicare Secondary Payer Act (MSP).  Also, the New Jersey Collateral Source Statute (“NJCSS”)did not apply to MSP reimbursement claims and collateral proceeds were reimbursable

English: image edited to hide card's owner nam...
English: image edited to hide card's owner name. author: Arturo Portilla (Photo credit: Wikipedia)
" For the reasons described above, the Court concludes that it lacks subject matter jurisdiction over Ms. Taransky's “due process” and “proportionality” claims, as Ms. Taransky failed to administratively exhaust these claims. Additionally, the Court concludes that there is substantial evidence in the record supporting the MAC's properly-reasoned conclusion that in obtaining a tort settlement in a trip-and-fall accident, and notwithstanding a state trial court's order allocating this tort settlement recovery to non-medical expenses, Ms. Taransky received payment from a “primary plan” responsible for payment of her medical expenses that had been covered by Medicare. As a result, Ms. Taransky is required to reimburse Medicare $10,121.15 pursuant to the MSP."

Taransky v. Sebelius, Civil Action No. 12-4437, 2013 WL 3892360 (D. NJ 2013) June 13, 2013