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April 15, 2018 at 02:46 PM
Miami litigator Alan D. Lash helped one of South Florida’s largest hospital systems beat back a putative class action lawsuit with the potential for far-reaching fallout.
The Lash & Goldberg partner worked with partner Greg Weintraub and senior counsel Dave Ruffner to represent Tenet Florida Inc. in closely watched litigation that once targeted insurance companies but now aims to recoup billions of dollars from hospitals across the country.
“This does have significant implications … industry-wide,” Lash said. “There are several of these actions that are pending in (Florida) and other states.”
Lash & Goldberg’s client, Tenet, operates 10 acute-care hospitals, three standalone emergency centers, urgent-care clinics and more than 20 surgical and diagnostic imaging offices in Miami-Dade, Broward and Palm Beach counties.
(Related: Hospitals Are Vanishing and Undoing the ACA May Make It Worse)
It is one of several hospital systems in the continental U.S. and Puerto Rico facing suit in federal court from a Medicare Advantage assignee looking to recover insurance payments under the Medicare Secondary Payer Act.
The plaintiff is linked to Miami-based MSP Recovery Law Firm, which claims hospitals collected billions of dollars from Medicare and Medicaid when other insurers should have paid.
Under federal law, the public health insurance programs are set up as secondary rather than primary payers. This means any other insurer should pay before Medicare or Medicaid covers the balance on claims.
But details that emerged last year suggested federal health officials lost hundreds of millions of dollars in overpayments to Medicare Advantage health plans under. At the time, NPR reported losses for 2007 alone were about $128 million and went unnoticed until an initial round of audits.
