(STL.News) – The United States Attorney’s Office for the Middle District of Pennsylvania announced that the Angino Law Firm, P.C., has agreed to pay the United States $53,295 to resolve liability under the Medicare Secondary Payer Statue (MSPS).
Enacted in 1980, the Medicare Secondary Payer Statue requires insurers to make the primary payment for services rendered by Medicare beneficiaries, leaving the Medicare program to provide benefits as a secondary payer. Under the MSPS, Medicare may make conditional payments for a beneficiary’s care, then seek reimbursement from a primary source such as a primary insurance company. The MSPS permits Medicare to seek reimbursement directly from a primary insurance company or another person, such as the Medicare beneficiary or the beneficiary’s attorney, who received payment from the primary insurer but does not remit the payment to Medicare.
According to U.S. Attorney David J. Freed, the Angino Law Firm represented a Medicare beneficiary, “the client,” in a state medical malpractice claim against Bloomfield Pharmacy, Inc. and Bio-Medical Applications of Pennsylvania, Inc., alleging that the pharmacies had dispensed an incorrect drug to the client. In 2011, Medicare conditionally paid approximately $84,353 for the client’s medical care. The Angino Law Firm settled the state medical malpractice claim in 2014 and received payment on behalf of the pharmacies. Under the Medicare Secondary Payer Statute, the Angino Law Firm was required to repay $53,295 to the Medicare Program. Because the Angino Law Firm refused to repay the Medicare Program, the United States filed suit to recover the money owed to the Government in July 2017.
After extension litigation in the district court, the parties agreed to amicably resolve the matter. Under the terms of the settlement, the Angino Law Firm paid the United States $19,545.15 and Bio-Medical Applications of Pennsylvania paid the Government $33,750, which had been set aside in escrow from the state medical malpractice settlement. The settlement agreement is not an admission of liability by any of the parties, but it does result in the Medicare Program being reimbursed the funds it expended for the client’s treatment.
“Medicare benefits are a vital lifeline for thousands of citizens in the Middle District of Pennsylvania,” said U.S. Attorney Freed. “Our Affirmative Civil Enforcement Unit is focused on making sure that such funds are appropriately billed and spent, and recovered when the situation requires. The health of our Medicare beneficiaries is far too important for our office to stand on the sidelines.”
This matter was litigated by the Affirmative Civil Enforcement (ACE) Unit within the U.S. Attorney’s Office and is assigned to Assistant U.S. Attorney D. Brian Simpson. The Office of General Counsel, U.S. Department of Health and Human Services, also assisted in this case. The case is docketed as U.S. v. Richard C. Angino.et al., Civ. No. 3:17-1193 (M.D. Pa.).