In Merrifield v. United States, Medicare beneficiaries brought a class action suit against the United States government and the Department of Health and Human Services on the theory that the defendants’ demand for reimbursement for medical expenses pursuant to the Medicare Secondary Payer Statute (MSP) was wrongful and in violation of plaintiffs’ constitutional due process rights.
Medicare paid for the plaintiffs’ medical expenses after they had sustained personal injuries in accidents.  New Jersey law prohibits the collection for the costs of any medical expenses already paid by Medicare in tort settlement.  Accordingly, plaintiffs’ settlements did not include any money for medical expenses that had been paid by Medicare.  Pursuant to the MSP, the Center for Medicare and Medicaid Services (CMS) demanded reimbursement for medical expenses from the settlements.
Plaintiffs argued that CMS was not entitled to reimbursement under the MSP provision because plaintiffs’ medical expenses were not covered by any other source.  Plaintiffs did not prevail despite the fact they had not recovered for medical expenses.  The suit was dismissed due to the plaintiffs’ failure to exhaust administrative remedies.  Plaintiffs were required to pay Medicare its reimbursement claim and to seek administrative remedies.
Date of Decision: June 30, 2009
Merrifield v. United States, Civil No. 07-987, United States District Court for the District of New Jersey, 2009 U.S. Dist. LEXIS 55377 (D.N.J. June 30, 2009) (Simandle, J.)