Justia Health Law Opinion Summaries

Plaintiffs, limited liability companies, filed class action lawsuits in the United States District Court for the District of Maryland seeking relief under the Medicare Secondary Payer (MSP) provisions. These provisions make Medicare a secondary payer when a beneficiary has other insurance coverage. Plaintiffs obtained assignments from Medicare Advantage Organizations and other secondary payers to seek reimbursement from primary payers like the defendants, Government Employees Insurance Company and its affiliates (GEICO). Plaintiffs had no preexisting interest in the claims and were compensated on a contingency basis.The United States District Court for the District of Maryland denied GEICO's motion to dismiss the case, which argued that the assignments were void as against Maryland public policy based on the doctrines of maintenance, champerty, and barratry. The court found no clear statement of Maryland law on this issue and certified questions to the Supreme Court of Maryland.The Supreme Court of Maryland held that Plaintiffs did not violate Maryland’s barratry statute, which prohibits soliciting another person to sue for personal gain without an existing relationship or interest. Plaintiffs did not solicit secondary payers to file lawsuits but obtained the right to sue in their own names through assignments. The court also held that the common law doctrines of maintenance, champerty, and barratry, to the extent they still apply, do not invalidate Plaintiffs’ assignments. The court concluded that the assignments are not void as against public policy and did not address the enforceability of choice-of-law provisions in the agreements. View "GEICO v. MAO-MSO Recovery II" on Justia Law

Janice Hollabaugh authorized her attorney to request her medical records from a health care provider for a personal injury claim. The provider contracted with MRO Corporation to fulfill the request. MRO sent a "Cancellation Invoice" to Hollabaugh’s attorney, stating that the request was canceled and charged a $22.88 fee for searching for the records, even though no records were produced. Hollabaugh reimbursed her attorney for the fee and subsequently filed a class action lawsuit against MRO, alleging that the fee violated the Confidentiality of Medical Records Act.The Circuit Court for Baltimore County determined that Hollabaugh had standing but concluded that the Act authorized MRO’s fee, leading to the dismissal of the case. The Appellate Court of Maryland affirmed the standing decision but also upheld the fee's authorization under the Act. Hollabaugh then petitioned the Supreme Court of Maryland, which granted certiorari to review the case.The Supreme Court of Maryland held that Hollabaugh had standing to sue because she reimbursed her attorney for the fee, creating a reasonable inference of injury. The Court further held that the Confidentiality of Medical Records Act does not permit a health care provider to charge a preparation fee for a search that does not result in the production of any medical records. The Court reasoned that the statutory language and context imply that fees are only authorized for the retrieval and preparation of existing records. Consequently, the Court affirmed the lower court's decision on standing but reversed the decision regarding the fee's authorization, remanding the case for further proceedings consistent with its opinion. View "Hollabaugh v. MRO Corporation" on Justia Law