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)
Showing posts with label Medicare reimbursement. Show all posts
Showing posts with label Medicare reimbursement. Show all posts
Saturday, June 28, 2014
Monday, December 10, 2012
Federal court denies motion to add Medicare secondary reimbursement claims to a pending class action
A United States District Court handling Vioxx litigation has denied as application to add Medicare reimbursement claims to the pending application.
"The Court has reviewed the briefs and finds that denying leave to amend is appropriate because the proposed joinder of these new Defendant Law Firms is not the most expeditious way to dispose of the merits of these matters. First, the Court finds that the proposed amendment violates Federal Rule of Civil Procedure 20. The Court previously granted a motion to sever the Plan Plaintiffs' claims pursuant to Rule 21(a). See AvMed II, 2008 WL 4681368, at *5–8. As the Court held in AvMed II, the Plan Plaintiffs' bring different claims pursuant to different health benefit plan language to pursue liens over funds owed to different claimants in different factual circumstances. See id. This diversity between the claims of the individual Plan Plaintiffs meant that the rights to relief asserted did not arise out of the same transactions or occurrences and did not present common questions of law or fact. See id. (citing Fed.R.Civ.P. 20(a)). Therefore, the Court recognized the risk of “transform[ing] this litigation into an action against approximately 15,000 defendants, each of whom has entered into a separately negotiated health plan contract and each of whom has received medical benefits under highly individualized factual circumstances.” See id. at *8. Accordingly, the Court exercised its discretion to sever the improperly-joined claims of the individual Plan Plaintiffs."
....
Jon L.Gelman of Wayne NJ, helping injured workers and their families for over 4 decades, is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson).
In re Vioxx Products Liab. Litig., MDL 1657, 2012 WL 6045910 (E.D. La. Dec. 4, 2012)
Read more about Medicare Reimbursement Claims
Mar 17, 2009
A private suit, brought by a consortium of plaintiff entities and individuals seeking reimbursement of Medicare for the failure of the tobacco companies' to repay The Centers for Medicare and Medicaid [CMS] for benefits, was ...
Oct 01, 2010
The 11th Circuit Court of Appeals has held that Medicare is not entitled to reimbursement under the Medicare Secondary Payer Act (MSP) when the the surviving children's allocated share of proceed is the result of a wrongful ...
Dec 01, 2012
By one estimate, under its current reimbursement system, Medicare is paying in excess of a billion dollars a year more for the same services because hospitals, citing higher overall costs, can charge more when the doctors ...
Nov 22, 2011
The 6th Circuit Court of Appeals has ruled that The Center for Medicare and Medicaid Services (CMS) is entitle to complete reimbursement of Medicare payments under the Medicare Secondary Payer Act (MSP) from a liability ...
Subscribe to:
Posts (Atom)