Estate of Ethridge v. Recovery Management Systems (CA1 2/13/14)

PLEASE NOTE that our link to the opinion now leads to the opinion  dated 5/13/2014, issued after a Motion for Reconsideration.

The case holds that Medicare part C (“Medicare Advantage”) plans have a lien against a personal-injury recovery. This will not surprise specialists in the mine field that this area of the law has become, though we’re happy to say we’re not among them. We mention the case because personal-injury practitioners will want to be aware of it.

Etheridge died in a nursing home; her estate sued the home; the case settled. The Advantage plan then sought reimbursement from the proceeds. The estate sued it for declaratory judgment. The trial court ruled for the plan; the Court of Appeals affirms.

Part C specifically pre-empts state law inconsistent with its “standards.” The court concludes that HHS regulations are Part C “standards” and that one of those regulations gives Advantage plan the same rights as traditional Medicare.

(link to opinion)