After several wins at the U.S. Court of Appeals for the 11th Circuit, MSP Recovery made history again obtaining class certification for Medicare Advantage Organizations based on the principles of Medicare Secondary Payer law, against IDS Insurance Company. On April 20, 2017, the Honorable Judge Antonio Arzola entered a 56-page Order Granting the Motion to Certify Class. Judge Arzola heard two days of argument, and testimony from the parties during an evidentiary hearing which took place in September 2016.
The Court agreed with MSP Recovery and acknowledged that in processing no-fault claims, IDS: (1) lacked specific guidelines to determine whether their insureds are or were Medicare eligible; and (2) failed to notify CMS about every instance in which it receives a no-fault claim from a Medicare beneficiary. This practice by IDS, and by many other no-fault insurers, causes Medicare Advantage Organizations to pay for health benefits for which the no-fault carrier is primarily responsible.
MSP Recovery overcame the attempts by IDS to disguise the case as a dispute for personal injury protection (PIP) benefits. Judge Arzola, who has consistently denied motions for class certification in cases involving PIP benefits, recognized that MSP Recovery’s case is a breach of contract case with the underpinnings of Medicare Secondary Payer Law, and not a PIP case. This victory comes just a few short months after the Honorable Judge Samantha Ruiz-Cohen also granted MSP Recovery’s Motion for Class Certification against Ocean Harbor Casualty Insurance in a factually similar context.
Obtaining class certification is no easy task, but MSP Recovery has developed a tried and true system which is comprehensive and accepted by the courts. The MSP System is able to discover and identify a Medicare eligible person for whom primary medical payments should have been made by another party, including no-fault insurers. This process allows MSP Recovery to visually show the court the claims being pursued and all potential class members.