Oregon Medicare Injury Settlement Class Action
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Oregon Medicare Class Action Lawsuit
In order to increase profits, medical providers secretly overbill Oregon Medicare patients after car accident settlements, in direct violation of the federal Medicare rules.
On November 30, 2015, Mr. Griffith was injured in a car accident. On October 18, 2017, PeaceHealth overbilled Mr. Griffith $14,574 after he settled his car accident claim. On March 7, 2018, Mr. Griffith disputed that PeaceHealth was entitled to the funds, and provided legal authority as to why it was not entitled to those funds. PeaceHealth, however, refused to correct its billings, and continued to maintain that Mr. Griffith owed $14,574. On April 23, 2018, Mr. Griffith paid the bill under protest.
PeaceHealth wrongfully took money from Mr. Griffith, leaving him no choice but to file this case. Mr. Griffith decided to file his case as a class action to stop Medicare overbilling practices once and for all, and to take back the millions of dollars wrongfully collected from injured Oregon Medicare patients over the past seven years.
Oregon Medicare patients who have settled an injury claim in the past seven years can visit www.MedicareClassAction.com to learn more about their legal options at no cost.
Except in Oregon liability cases, federal regulations allow Medicare providers like PeaceHealth to elect not to bill Medicare for a patient’s injury-related pre-settlement Medicare covered services. Instead, Medicare providers may elect to directly bill the liability injury settlement.
Oregon is the only state that is different. In liability cases, 42 C.F.R. § 411.54(d)(2), “Special Rules for Oregon” allow Oregon Medicare providers to bill an injury settlement only under limited circumstances.
Based upon Oregon Ass’n of Hospitals v. Bowen, 708 F. Supp. 1135 (D. Or. 1989), Oregon Medicare providers may elect to bill a liability insurer or place a lien against the liability settlement only if the liability insurer pays within 120 days after the earlier of (A) the date of filing a claim with the insurer or placing a lien against the liability settlement, or (B) the date the services were provided or the date of inpatient discharge. The term “overbill” refers to PeaceHealth’s ongoing practice of billing liability settlements for covered services provided to Oregon Medicare beneficiaries after an injury, in violation of 42 C.F.R. § 411.54(d)(2).