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Render unto Caesar
A 70-year-old man was admitted to the hospital for a bowel resection. Following surgery, the patient's condition worsened considerably; He spent months in the ICU on a ventilator, was fed through a gastrostomy tube, and his mental status waned. After some time, it was suspected that his deteriorating condition might be related to sepsis from a bowel perforation. Subsequent surgery confirmed this diagnosis. Attempts to repair the perforation failed, and, ultimately the patient died.
Medicare paid the patient's medical bills, which exceeded $500,000. The patient's family commenced a lawsuit, alleging that the surgeon's negligence caused the bowel perforation. During the litigation, the Medicare Trust Fund sent a correspondence to the patient's estate, asserting a claim of reimbursement for the benefits Medicare paid from any recovery that the estate might obtain.
This scenario is no doubt familiar for those who litigate medical malpractice cases. Whether the federal government maintains a valid right of reimbursement is important to both plaintiffs and defendants. If plaintiffs must reimburse the government from a recovery for Medicare benefits they receive, then litigants must account for that during settlement negotiations. This may make settlements difficult or even impossible to work out, especially when the lien amount exceeds the value of the case.
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