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In Hadden v. United States, plaintiff was injured when he was struck by a utility truck. The utility truck had lost control when it was run off the road by another car that ran a stop sign. The car responsible for the accident was never identified. Medicare paid for plaintiffs’ medical expenses related to the accident. Plaintiff settled his claims against the owner of the utility truck and signed a release in which he agreed to pay and satisfy all medical expenses, liens, and claims related to the incident. Plaintiff agreed to settle with the party based on what he perceived to be the fault allocation of the settling defendant. Plaintiff was ordered to pay Medicare its reimbursement even though the liable tortfeasor was never found.
Date of Decision: August 6, 2009
Hadden v. United States, CASE NO.: 1:08-CV-102009, United States District Court for the Western District of Kentucky, U.S. Dist. LEXIS 69383 (W.D. KY, Aug. 6, 2009) (Russell, J.)
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.)