MIAMI – A federal judge recently dismissed a Medicare beneficiary reimbursement company's consolidated class action, saying 14 times is plenty of chances for the company to plead its case.
The plaintiff, Medicare Secondary Payer (MSP) Recovery Claims Series, with its own evidence confirmed it could not show it had standing under the Medicare Secondary Payer Act, noted U.S. District Court Judge Patricia A. Seitz of the Southern District of Florida in her April 25 order granting a defense motion to dismiss with prejudice. "Despite its 14th attempt at pleading its claims, plaintiff has still failed to allege that any of its assignors are Medicare beneficiaries, MAOs [Medicare Advantage organizations] or medical providers that directly treated the Medicare beneficiaries in these claims," Seitz said in her 13-page order.
U.S. District Court Judge Patricia A. Seitz of the Southern District of Florida
Wrote the judge: "As the evidence shows, this defect cannot be cured. Plaintiff's assignors simply are not within the purview of the parties who can begin a claim under the [Medicare Secondary Payer Act]."
MPS Recovery is a business that obtains "assignments from Medicare Advantage organizations, first-tier entities and downstream entities to recover reimbursement for payments made for the medical expenses of Medicare beneficiaries that should have been made by a private insurer pursuant to the Medicare Secondary Payer Act," Seitz said in the background portion of her order.
The case Seitz dismissed, in which defendants included Auto-Owners Insurance and Southern-Owners Insurance, is one of "hundreds of similar cases being brought by MSP Recovery in state and federal courts nationwide," MPS Recovery said in a statement issued about a year ago.
"To identify claims, MSP Recovery uses its proprietary technology to identify primary payers who improperly billed Medicare entities," the MPS Recovery statement said. "Using this system, the 30-attorney MSP Recovery Law Firm is working with approximately 30 partner law firms nationwide to file lawsuits across the country on behalf of more than 100 health insurance plans."
In its consolidated complaint before Seitz, MPS Recovery sued for reimbursement from defendants for Medicare payments on behalf of Medicare beneficiaries under the Medicare Secondary Payer Act. Defendants in their motion for the case to be dismissed claimed MPS Recovery lacked standing and failed to state a claim.