Class Action Claims State Farm Failed to Reimburse Medicare Payments

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A proposed class action recently removed from state to federal court in Florida alleges defendant State Farm Mutual Automobile Insurance Company failed to reimburse Medicare secondary payers that cover the medical expenses of the insurance company’s plan members.

According to the complaint, one of the defendant’s plan members (a non-party to this lawsuit) was injured in a May 29, 2014, automobile accident for which he was not at fault. Florida Healthcare Plus (FHCP) reportedly paid for the man’s medical expenses through its Medicare program. Since then, the man’s account has been assigned to the plaintiff company for collection, the case explains.

The lawsuit argues that under the Medicare as Secondary Payer Act, an injured person’s workmen’s compensation, liability insurance, self-insurance, or no-fault insurance are considered the primary payers for his or her medical expenses, with the Medicare program being the secondary payer. The law allows for the secondary payer to make a conditional payment if the primary payer has not already paid, but this payment must be reimbursed by the primary payer, the complaint explains.

In this case, FHCP paid for the injured man’s expenses and was never reimbursed by State Farm, the primary payer. The plaintiff company now seeks reimbursement for the patient’s medical expenses, which the case says exceeded $14,000.