Phillips v. Kaiser Health Plan, Inc., et. al.
No. C 11 – 02326 CRB
2011 WL 3047475 (N.D.Cal.July 25, 2011)
This case involved a putative class action filed against Kaiser Health Plan, Inc. (Kaiser), a Medicare Advantage (MA) Plan, and other related MA entities.
The plaintiff alleged that (a) Kaiser was improperly and “illegally” demanding reimbursement of its accident related medical expenditures in an amount greater than that which would have been recoverable under traditional Medicare, and (b) that certain marketing and business practices employed by Kaiser violated California’s Unfair Competition Law and Consumer Legal Remedies Act.
The plaintiff filed this case in California state court, which Kaiser removed to the United States District Court for the Northern District of California (hereinafter referred to as the “court”). This case then came before the court on (a) the plaintiff’s motion to remand and (b) Kaiser’s motion to dismiss. Continue reading “Phillips v. Kaiser Health Plan, Inc., et.al.”
Humana Medical Plan, Inc. v. Mary Reale
No. 10-21493-Civ., 2011 WL 335341 Jan. 31, 2011
(D. S.D. Fla, January 31, 2011)
Parra v. Pacificare of Arizona, Inc.
No. CV 10–008–TUC–DCB, 2011 WL 1119736
(D. Arizona, March 28, 2011)
The main issue presented in these cases involved whether Medicare Advantage Plans could assert their recovery actions in the federal court (i.e. whether or not the federal courts had proper jurisdiction over these claims)
For the reasons more outlined in the case decisions, the courts basically ruled that the federal courts did not have proper subject matter jurisdiction to hear these cases. In reaching this decision, the courts essentially found that while the MSP provides Medicare Advantage Plans with recovery rights, these plans do not enjoy the same rights as the federal government in terms of recovery claims in federal court. It is important to note that the courts did not rule that Medicare Advantage Plans do not have recovery rights. Rather, the courts in these cases ruled that the federal courts did not have jurisdiction over recovery actions involving Medicare Advantage Plans. Continue reading “Humana Medical Plan, Inc. v. Mary Reale & Parra v. Pacificare of Arizona, Inc.”