Sixth Circuit District Court Recognizes Medicare Advantage Organizations' Rights to Private Cause of Action
Brendon De Souza
On March 28, 2022, a Sixth (6th) Circuit District Court issued an opinion which held that the Medicare Secondary Payer (“MSP”) Act’s private cause of action, 42 USC §1395(y)(b)(3)(A), may be wielded by Medicare Advantage Organizations (MAOs) to pursue double-damage recoveries against primary payers who fail to reimburse the MAO conditional payments. MSP Recovery Claims, Series LLC v. Nationwide Mut. Ins. Co., LEXIS 55717 (S.D. Ohio Mar. 28, 2022).
Although the Sixth ...
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