In an article for CLM Magazine, MARC Coalition’s Heather Sanderson urges primary plans to consider best practices as courts rule in favor of Medicare Advantage Plans (MAP) recovering double damages. Sanderson astutely notes that with both the 3rd and 11th Circuit Courts finding in favor of MAPs being allowed to bring an Medicare Secondary Payer (MSP) private cause of action for double damages, industry is seeing “widespread” application of the double damages across the country. “The ease with which courts have determined a MAP can allege a sufficient double-damages MSP private cause of action claim is alarming,” writes Sanderson. “A recent district court case out of Illinois found that, for a MAP to allege an MSP private cause of action, it simply needs to allege that there is no genuine issue of material fact regarding the defendant’s status as a primary plan, the defendant’s failure to provide for primary payment or appropriate reimbursement, and the damages amount.”
The article in its entirely can be read here.