Meek-Horton v. Trover Solutions

U.S. DISTRICT COURT
SOUTHERN DISTRICT OF NEW YORK
Social Services Law

New York Law Journal

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District Judge Robert Patterson

Private health insurer Trover Solutions and its co-defendants administer Medicare Advantage Plans (MA Plans). They seek reimbursement for benefits paid to Meek-Horton through liens on personal injury and wrongful death settlements received from third-party tortfeasors. Like traditional Medicare, the Medicare Advantage Program—commonly called "Medicare Part C"—makes Medicare Advantage Organizations the secondary payers, and third-party entities such as insurance policies and Workers' Compensation plans, the primary payers. Claiming that defendants' reimbursement claims violate New York General Obligations Law §5-335, Meek-Horton and her co-plaintiffs sought restitution from defendant insurers, and a permanent injunction against reimbursement. Discussing Potts v. Rawlings and Uhm v. Humana, the court dismissed plaintiffs' action—removed under the Class Action Fairness Act—finding that Medicare Part C preempted GOL §5-335. In Part C, Congress expressly preempted all but a limited number of state laws. Given that GOL§5-335, the sole basis for plaintiffs' claims, was expressly preempted by federal law and agency regulation, plaintiffs' lawsuit contained no claims on which relief could be granted.

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