Angry Medicare Beneficiary Sues MSPRC

Commentary, Medicare Set-Aside Blog, MSP Litigation on April 19, 2013
Posted by Jennifer Jordan, JD, MSCC

…and got her case dismissed this week by the US District Court for the Eastern District of New York. No brainer given lack of subject matter jurisdiction, but since the court felt compelled to write an opinion (although labeled not for publication), I felt compelled to share it with you. You see, Maria L. Banks-Gervais was a pro se claimant and it appears that the court wanted her to understand why her claim lacked merit.

In September of 2010, Ms. Banks-Gervais was obviously injured in “an incident” sufficient that Medicare eventually paid medical bills related to her care. She obviously sued the alleged negligent party in 2012 and that act triggered MSPRC to send a Rights and Responsibilities Letter. As we know, that letter outlined the recovery process and the government’s rights and that apparently angered her sufficiently to sue the “Medicare Contractor.” Because I enjoyed how it appeared in the opinion so much, I do not want anything to get lost in translation. Her complaint was described as follows:

Banks argues that “Medicare should ask the Hospital
to refund them of the money paid . . . not the patient.”
Compl. ¶ III. And she requests, “[s]top the [r]aid of my
[g]overnment [b]enefits and other patient accident
victims[.] Recovery of the [g]overnment money from the
[h]ospital . . . [n]ot from ME.” Compl. ¶ IV.

Isn’t that cute? So that there is a legal lesson to be derived from this post, her case was tossed because she did not exhaust her administrative remedies. She was not complaining over an amount in question or that her “government benefits” were denied to her in her time of need when lack of medical care could have potentially been life threatening. No, instead she’s angry that she might have to pay it back should she recover from the alleged negligent party. And that is what she filed suit for. Sadly for her, there is no cause of action for “that’s mine and the government has no right to take it from me;” otherwise, the courts would be full of angry taxpayers all the time.

MARIE L. BANKS-GERVAIS, Plaintiff, – versus – MEDICARE CONTRACTOR, Defendant.
12-CV-6339 (JG)
2013 U.S. Dist. LEXIS 55094
April 16, 2013