Welcome to the Complex World of Medicare Secondary Payment Recovery


When you’re in your 20s, you don’t really spend a lot of time thinking about Medicare. The most you ever hear about this stuff is either from your parents or those commercials that run during daytime television.

The health-care reporters and editors at Bloomberg Law are experts on these topics, so when you hear them say an issue is complicated, then you really know you’ve hit a mind-spinning subject.

And so that’s exactly where I found myself last week writing my article Medicare Repayment Suits Against Hospitals Not Abating.

To make a long story short, three judges in Florida made varying rulings as to whether Medicare managed care organizations or contractors working on their behalf can recover Medicare payments from health-care providers. And, oh yeah, the decisions were all made in the course of one month. So I’m not kidding when I tell you that this is a fluid area of the law.

It’s one that’s growing, too. It’s been pretty typical to see lawsuits to recover payments from primary insurers, like car insurance. This idea of filing suits against hospitals and other health-care providers, however, is relatively new.

The lead attorneys I spoke with for the story, who disagreed on just about everything, are in agreement that this is a growing area of law. And the varying decisions by the judges indicates that it can be interpreted in many varying and conflicting ways.
So sit down and strap in!

When you’re in law school, there’s a running joke that lawyers ultimately love nothing more than arguing about the meaning of words. These suits, which largely deal with interpreting the Medicare Secondary Payer law, go a long way to proving that is true.

And like at least some of your Facebook friends’ relationship statuses, it can all be wrapped up in two words: It’s complicated.

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