Is Medicare Advantage Entitled To Bring A Private Cause Of Action Under The Medicare Secondary Payer Act?

CMS, Medicare, Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation on June 24, 2015 | Posted by Kimberly Wiswell, CMSP

This law review article by Jennifer Jordan, general counsel at MEDVAL, was recently published in the William Mitchell Law Review. It’s an in-depth analysis of the current state of Medicare Advantage recovery rights and provides a well-reasoned rationale as to whether or not MAOs were intended to share exactly the same recovery rights as traditional Medicare. Due to the lack of proposed legislation to clear up the inconsistencies in the application of the Medicare Secondary Payer Act to MAOs, this article also compares judicial outcomes to identify why the results evolved as they have and illustrates why those decisions may be in error. Ultimately, a case is made for legislative reform because Medicare Advantage is still a secondary payer under the Medicare Act and, as such, is entitled to reimbursement, through whatever means Congress deems appropriate. To read the full article click here.