Disability Law

Medicare Sues Plaintiff's Attorney for Unreimbursed Medical Expenses

By David A. McCranie, Esq.

Consider these facts:

• Medicare beneficiary is injured in a fall from a ladder.  Medicare expends $22,549.67 in payment of beneficiary's resulting medical bills.  Beneficiary hires an attorney who files suit against the ladder retailer.  Suit settles for $25,000, and attorney notifies Medicare of settlement.  Medicare calculates that it is owed $10,253.39 from the settlement, but attorney fails to forward this amount to Medicare. 

These were the facts pleaded in Medicare's suit against the attorney to recover these expenses pursuant to 42 U.S.C. §1395y(b)(2)(B)(iii) in U.S. v. Harris, and they were sufficient to survive the attorney's motion to dismiss the suit under Fed. R. Civ. P. 12(b)(6).  You can read the 11/13/2008 order from the Federal District Court for the Northern District of West Virginia here. 

The lesson?  Be sure to protect Medicare's interest when settling your workers' compensation claim.  Tip of the hat to the the Medicare Set-Aside Blog for alerting us to this case.

Full post as published by Florida Workers’ Compensation Law Blog on January 11, 2009 (boomark / email).