More Attempts to Recover on Behalf of MAOs Result in Dismissals

As we last reported in December, there has been increasing efforts by select organizations to seek to recovery under the Medicare Secondary Payer Act (MSPA) on behalf of Medicare Advantage Organizations. In the last month alone, there have been two decisions on cases involving almost thirty defendant insurance companies. The decisions at issue both resulted in a dismissal due to lack of jurisdiction, however, as the frequency of filings demonstrates, this will not be the last of these types of cases.

In the first case decided this month, MSP Recovery Claims v. Amerisure Ins. Co., No. 17-23961-CIV-ALTONAGA/Goodman, 2021 U.S. Dist. LEXIS 20464 (S.D. Fla. Feb. 1, 2021) , the Court found that the Plaintiffs lacked standing, as the complaints did not include any factual allegations of an instance illustrating Plaintiffs’ assignors suffered an injury in fact. The complaint did not identify a single specific beneficiary, policy, expense, or unreimbursed payment. The Court did, however, permit the Plaintiffs a short time to amend the complaint to show that one or more of Plaintiffs' assignors suffered an injury in fact. While the other recent case, MSP Recovery Claims Series, LLC v. Nationwide Mut. Ins. Co., Civil Action No. 20-21573-Civ-Scola, 2021 U.S. Dist. LEXIS 19384 (S.D. Fla. Feb. 2, 2021) , did at least include exemplar claims that detailed specific accidents and expenses, the Court found that the Plaintiffs lacked general and personal jurisdiction. The Plaintiffs in this case were not given the benefit of amending the complaint.

Given the incredible effort to establish and execute recovery for these Plans, it is as important as ever that you research and resolve any Medicare Advantage and Prescription Drug Plan liens as a part of settlement. Should you need assistance with Advantage or Drug Plan lien research, or simply have questions regarding the same, we are always here to help.