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Federal Court Dismisses Cases Seeking to Recover on behalf of MAO, Allows Another to Proceed

The United States District Court for the Southern District of Florida has issued more decisions in a line of cases filed by an entity seeking to recover conditional payment claims made by Medicare Advantage Organizations (MAO). MSP Recovery Claims v. United Auto Ins. Co., 20-20887-CIV-ALTONAGA, 2021 U.S. Dist. LEXIS 37013 (S.D. Fla. Feb. 4, 2021); MSP Recovery Claims v. Endurance Am. Ins. Co., 20-23219-Civ-Scola, 2021 U.S. Dist. LEXIS 32865 (S.D. Fla. Feb. 23, 2021); and MSP Recovery Claims v. Metro, 20-24052-Civ-Scola, 2021 U.S. Dist. LEXIS 39208 (S.D. Fla. March 3, 2021).

In each case the Plaintiffs, MSP Recovery Claims, asserted that it had been assigned authority from an MAO to recover conditional payments made by the MAO on behalf of the Defendants’ insureds. The Defendants’ in each case moved to dismiss for lack of standing and failure to state a claim.

In United Auto, the court determined that the Plaintiffs succeeded in showing assignment of the right to seek reimbursement of conditional payment claims on behalf of the MAO and asserted facts sufficient to state a claim under the MSPA private right of action. As such, the Defendants’ Motion to Dismiss was denied, and the matter will proceed to the next stages of litigation.

The court held in Endurance, however, that the Plaintiffs failed to show that the exemplar case they put forward was actually assigned to them by the MAO. In Endurance, the MAO assigned recovery rights to the Plaintiffs for only a limited line of cases. The court dismissed the matter without prejudice for lack of standing. Further, in Metro, the court granted the Defendants’ Motion to Dismiss, holding that the Plaintiffs failed to assert a cognizable claim under the MSPA.

As we have noted, there is no indication that efforts by these purported assignees to recoup conditional payment claims will cease. It is imperative that the interests of Medicare Advantage Plans and/or Prescription Drug Plans be considered as part of settlement, along with the interests of Medicare itself. We are happy to help you navigate this process and answer any questions you may have!


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