#EleventhCircuit

U.S. District Court Upholds Dismissal of Claim Brought Under the Private Cause of Action Provision o

Melisa Zwilling

Apr 27, 2017

U.S. District Court Upholds Dismissal of Claim Brought Under the Private Cause of Action Provision o

In the present case, Claims v. Co. V., No. 16-20338-CIV-LENARD/GOODMAN, 2017 U.S. Dist. Ct. LEXIS 43755, the Plaintiff (MSPA Claims 1, LLC) alleges that the Defendant (Covington Specialty Insurance Company) violated the Medicare Secondary Payer Act (MSP) by failing to reimburse payments made by a beneficiary’s Medicare Advantage Plan (MAP) provider for medical expenses incurred related to an accident for which Defendant was the primary payer. The Defendant insurer provided a

U.S. District Court Again Follows Eleventh Circuit Decision Finding that the Existence of a Contract

Melisa Zwilling

Mar 31, 2017

U.S. District Court Again Follows Eleventh Circuit Decision Finding that the Existence of a Contract

MSP Recovery, LLC v. Allstate Ins. Co., No. 15-21532, 2017 U.S. Dist. LEXIS 41424 (U.S. Dist. S.D. Fla., March 21, 2017) was recently back before the United States District Court for the Southern District of Florida, again on a motion to dismiss. As you may recall, this case was one of the seven consolidated cases included in the Eleventh Circuit decision finding that a contractual obligation alone could satisfy the “demonstrated responsibility” requirement of the private cau

U.S. District Court Again Relies on Eleventh Circuit Decisions And Allows Medicare Advantage Organiz

Melisa Zwilling

Mar 31, 2017

U.S. District Court Again Relies on Eleventh Circuit Decisions And Allows Medicare Advantage Organiz

In the recent case, Mspa v. Century Sur. Co., No. 16-20752, 2017 U.S. Dist. LEXIS 37040 (U.S. Dist. S.D. Fla., March 15, 2017), the United States District Court for the Southern District of Florida once again considered the rights of Medicare Advantage Organizations (MAOs) to seek reimbursement of medical expenses under the Medicare Secondary Payer Act (MSP). In this case, the enrollee of Florida Healthcare Plus, a Medicare Advantage Organization (MAO), was injured on propert

U.S. District Court Looks To Eleventh Circuit Decision In Deciding Medicare Advantage Organization’s

Melisa Zwilling

Mar 27, 2017

U.S. District Court Looks To Eleventh Circuit Decision In Deciding Medicare Advantage Organization’s

In September 2016, we informed you of an Eleventh Circuit decision in which the Circuit Court found that a contractual obligation alone was enough to establish demonstrated responsibility as required in order to bring a claim under the private cause of action provision of the Medicare Secondary Payer Act (MSP) (see MSP Recovery, LLC v. Allstate Ins. Co., 2016 U.S. App. Lexis 15984). The present case, Claims v. Infinity Auto Ins. Co., No. 15-2504-civ-KING/TORRES, 2017 U.S. Dis

Alert! Eleventh Circuit: Contractual Obligation Sufficient to Establish “Demonstrated Responsibility

Melisa Zwilling

Sep 21, 2016

Alert! Eleventh Circuit: Contractual Obligation Sufficient to Establish “Demonstrated Responsibility

What qualifies as a “demonstrated responsibility” sufficient to proceed under the private cause of action provision of the Medicare Secondary Payer Act has been a recent hot topic of discussion. Following the Eleventh Circuit’s decision in Glover v. Liggett Group, several courts found that a contractual relationship alone would not suffice. Recently, however, the Eleventh Circuit Court of Appeals issued a decision that will change the way that we think about this requirement

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