Medicare Reimbursements.

Under 42 U.S.C. 1395y(b)(2)(B) (ii) a primary plan or an entity that receives payment from a primary plan shall reimburse Medicare once the primary plan’s responsibility has been demonstrated by a judgment or settlement. A federal judge in Arizona enjoined the Secretary of Health and Human Services from seeking up-front reimbursement of Medicare secondary payments from beneficiaries who have received payment from a primary plan if they have unresolved appeals of their Medicare reimbursement calculations or unresolved requests for waiver of their reimbursement obligations. The trial court also enjoined the Secretary from demanding that attorneys withhold settlement proceeds from their clients until after Medicare is reimbursed. The Ninth Circuit reversed, concluding the Secretary’s payer provisions are reasonable. The appeals court vacated the injunctions and remanded for consideration of the beneficiaries’ due process claims.  In its opinion, the court stated: “The complaint alleges only that the Secretary’s demand that attorneys withhold funds from their clients exceeds her authority under the secondary payer provisions. The Secretary’s authority to bring an action against an attorney who has disbursed the proceeds is not a controversy ripe for our review.” Haro v. Kathleen Sebelius  v. (Ninth Cir.; September 4, 2013) (Case No. 11-16606).