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The United States District Court of the Central District of Florida has granted Defendants’ motion for summary judgment in a line of cases filed by MAO-MSO Recovery II, LLC, an entity seeking to recover conditional payments made by Medicare Advantage Organizations (MAO). See MAO-MSO Recovery II, LLC v. Farmers Ins. Exchange, 2022 U.S. Dist. LEXIS 96039 (C.D. Fla. May 25, 2022) and MAO-MSO Recovery II, LLC v. Farmers Ins. Exchange, 2022 U.S. Dist. LEXIS 96049 (C.D. Fla. May 25, 2022). These cases mirror the scores like it filed in federal courts across the country, where plaintiffs file deficient complaints, rely on courts to point out the problems, and then repeatedly amend their pleadings until they get it right. Here, the Court held that the plaintiff’s Fourth Amended Complaint failed to provide admissible evidence that the payments for which they seek reimbursement were made to compensate medical providers for treatment sustained by Medicare beneficiaries. Thus, plaintiffs’ claims failed for lack of proof and lack of standing. Plaintiffs’ claims also failed based on the statute of limitations as CMS confirmed, for all but two claims, that it received notice of the claim more than three years before the claim was added to the lawsuit.

Efforts by purported assignees, like the plaintiffs in these cases, to recover conditional payments continue across the country. Parties should be sure to resolve Medicare Advantage and Prescription Drug plan liens as part of settlements, in addition to conditional payments made by traditional Medicare. Should you have any questions regarding conditional payment resolution with Medicare, Medicare Advantage, and/or Medicare Prescription Drug plans, or need assistance with the same, our team is available and happy to help.


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