Insurance company obtains dismissal in putative class actions asserting Medicare secondary payer claims

Client(s) Insurance company

Jones Day obtained dismissals on behalf of an insurance company in two related putative class actions brought in the Southern District of Ohio alleging liability under the Medicare Secondary Payer provision of the Medicare Act. The cases were brought by a group of plaintiffs claiming to be assignees of private health care plans that provided coverage to Medicare beneficiaries for injuries allegedly covered by policies issued by the insurance company. They alleged that the insurance company violated the Medicare Secondary Payer provision by failing to reimburse the plaintiffs' assignors for payments made on behalf of the Medicare beneficiaries. The court granted the insurance company's motions to dismiss in both cases, refusing to grant the plaintiffs leave to amend their complaints. In so doing, the court agreed with the insurance company that plaintiffs failed to adequately plead the existence of their purported assignments, and noted that the plaintiffs failed to plead many of the necessary elements to support their claims.