Subject Matter: Medicare Liens
In this Kentucky case, the Plaintiff had received $82K in medical expense benefits and settled his negligence claim for $125K, which he claimed was 10% of his actual damages. Medicare, an ALJ, the Medicare Appeals Panel, the U.S. District Court for the Western District of Kentucky and the 6th Circuit Court of Appeals all agreed that Medicare was entitled to full reimbursement out of the settlement proceeds, not just 10% of the medical benefits paid. The opinion does not address what would have happened if the settlement had been for less than the reimbursement claim, but the reasoning indicates that Medicare could have come after the settling tortfeasor for any shortage.
Shared by: Gwin, Steinmetz & Baird
Firm/Company: US Court of Appeals 6th Ct.
Document Date: January 1, 1970
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