Hadden v. U.S.

U.S. v. Hadden
No. 1:08-CV-10, 2009 WL 2423114
(D. W.D. Ky, Aug. 6, 2009)

This case involved a pedestrian plaintiff, Mr. Hadden, who was struck by a utility truck as he was walking on a sidewalk. The accident was caused when an unidentified driver ran a stop sign thereby cutting off the utility truck causing it take evasive action. In doing so, the utility struck Mr. Hadden causing bodily injury. Mr. Hadden sued the utility truck driver but was unable to file suit against the driver who ran the stop sign (the phantom tortfeasor) as he/she could not be found.

Mr. Hadden eventually reached a settlement with the utility truck driver in the amount of $125,000. Medicare issued a conditional payment demand upon Mr. Hadden for approximately $64,252.37 (said figure representing the full amount of the conditional payments issued by Medicare less applicable procurement costs). Continue reading “Hadden v. U.S.”

Zinman v. Shalala

Zinman v. Shalala
67 F.3d 841 (9th Cir. 1995)

The Zinman case involved a class action law suit filed by Medicare beneficiaries challenging the amount of Medicare’s conditional payment recovery in the context of discounted third party tort (liability) settlements.

The beneficiaries sued the Department of Health and Human Services (HHS) arguing that under the Medicare Secondary Payer Statute (MSP) Medicare was required to accept a pro rata reduction of its Medicare conditional payment claim in situations where a beneficiary received a third party settlement for less than its full value.  HHS took the position that Medicare was entitled to a full recovery of its conditional payments in such situations, less applicable procurement costs and subject only to the possible full or partial hardship waiver under the MSP. Continue reading “Zinman v. Shalala”