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[Net-Gold] [Workers' Compensation] Medicare Denied Reimbursement

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  • David P. Dillard
    . Date: Fri, 1 Oct 2010 01:46:24 -0700 (PDT) From: Jon L. Gelman Reply-To: Net-Gold@yahoogroups.com To: net-gold@yahoogroups.com Subject:
    Message 1 of 1 , Oct 1, 2010
      .



      Date: Fri, 1 Oct 2010 01:46:24 -0700 (PDT)
      From: Jon L. Gelman <jon@...>
      Reply-To: Net-Gold@yahoogroups.com
      To: net-gold@yahoogroups.com
      Subject: [Net-Gold] [Workers' Compensation] Medicare Denied Reimbursement





      .


      [Workers' Compensation]
      Medicare Denied Reimbursement



      The 11th Circuit Court of Appeals
      has held that Medicare is not
      entitled to reimbursement under
      the Medicare Secondary Payer Act (MSP)
      when the the surviving children's
      allocated share of proceed is the
      result of a wrongful death claim.
      The Court reasoned that under Florida
      law, any claim of the estate is
      separate and distinct from the claim of
      a survivor. Under Florida law, child's
      loss of parental companionship
      claim is a property right belonging
      to the child.



      Medicare through the Secretary of
      Health and Human Services (HHS) did
      not participate in the Florida probate
      action. HHS had refused to recognize the
      validity of that decision of allocation
      of the Florida Probate action.



      "Counsel for the survivors and the
      estate acted sensibly, in a
      cost-effective manner. The nursing
      home neglect claim was settled for
      the full value of the available
      insurance. Clearly, if the language of
      the field manual applied, in practice,
      it would lead to an absurd
      Catch-22 result. Forcing counsel to
      file a lawsuit would incur
      additional costs, further diminishing
      the already paltry sum available
      for settlement. This flies in the
      face of judicial and public policy.



      "The Secretary's position would have
      a chilling effect on settlement.
      The Secretary's position compels
      plaintiffs to force their tort claims
      to trial, burdening the court system.
      It is a financial disincentive to
      accept otherwise reasonable settlement
      offers. It would allow tortfeasors to
      escape responsibility.



      "Without citing any statutory authority,
      regulatory authority, or case
      law authority, the Secretary and the
      district court's reliance upon
      language in a field manual is unpersuasive.
      The Secretary is not entitled to any share
      of the Burke surviving children's loss of
      parental companionship claims.



      The decision may have a sweeping
      national impact on workers'
      compensation dependency claims, as
      they are also separate and distinct
      actions against an employer.



      Bradley v, Sebelius, ____F. 3d _____,
      2010 WL 3769132 (C.A. 11 Fla. 2010)



      For over 3 decades the Law Offices
      of Jon L. Gelman 1.973.696.7900
      jon@... have been representing
      injured workers and their families who
      have suffered work related accident
      and injuries.



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      --



      Posted By Jon L. Gelman
      to Workers' Compensation
      at 10/01/2010 04:46:00 AM

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