There is another provision for mandatory 5 year interviews with all
nursing home residents which sounds spooky. This bill is a hoax and
happily some congressmen are getting booed and heckled in their home
districts. Voters who call their representives to oppose the bill are
getting insulted as being unpatriotic.// If one is lucid, buy a
Winnebago and move near a loving child rather than submit to Obama's
plan for culling the population on his terms.

On Jul 21, 5:18�pm, dick thompson <[email protected]> wrote:
> � Medicare qui tam: a health care bill surprise
>
> by Walter Olson <http://overlawyered.com/author/walter-olson/> on July
> 17, 2009
>
> Contacts on Capitol Hill inform me that Republicans yesterday managed to
> block a remarkable provision that had been slipped into the House
> leadership's 794-page health care bill just before it went to a House
> Ways & Means markup session. If their description of the provision is
> accurate --- and my initial reading of the language gives me no reason
> to think it isn't --- it sounds as if they managed to (for the moment)
> hold off one of the more audacious and far-reaching trial lawyer power
> grabs seen on Capitol Hill in a while.
>
> For some time now the federal government has been intensifying its
> pursuit of what are sometimes known as "Medicare liens" against third
> party defendants (more
> <http://www.pointoflaw.com/archives/2009/06/medicare-liens.php>). In the
> simplest scenario --- not the only scenario, as we will see below ---
> someone is injured in, say, a car accident, and has the resulting
> medical bills paid by Medicare. They then sue and successfully obtain
> damages from the other driver. At this point Medicare (i.e. the
> government) is free to demand that the beneficiary hand over some or all
> of the settlement to cover the cost of the health care, but under some
> conditions it is also free to file its own action to recover the medical
> outlays directly from the negligent driver (who in some circumstances
> might even wind up paying for the same medical bills twice). It might do
> this if, for example, it does not expect to get a collectible judgment
> from the beneficiary.
>
> The newly added language in the Thursday morning version of the health
> bill (for those following along, it's Section 1620 on pp. 713-721) would
> greatly expand the scope of these suits against third parties, while
> doing something entirely new: allow freelance lawyers to file them /on
> behalf of the government/ --- without asking permission --- and collect
> rich bounties if they manage thereby to extract money from the
> defendants. Lawyers will recognize this as a /qui tam/ procedure, of the
> sort that has led to a growing body of litigation filed by freelance
> bounty-hunters against universities, defense contractors and others
> alleged to have overcharged the government.
>
> It gets worse. Language on p. 714 of the bill would permit the lawyers
> to file at least some sorts of Medicare recovery actions based on "any
> relevant evidence, including but not limited to relevant statistical or
> epidemiological evidence, or by other similarly reliable means". This
> reads very much as if an attempt is being made to lay the groundwork for
> claims against new classes of defendants who might not be proved liable
> in an individual case but are responsible in a "statistical" sense. The
> best known such controversies are over whether suppliers of products
> such as alcohol, calorie-laden foods, or guns should be compelled to pay
> compensation for society-wide patterns of illness or injury.
>
> A few other highlights of the provision, pending analysis by persons
> more familiar with Social Security and Medicare law than myself:
>
> � � * A bit of language on p. 714, I am told, would remove a significant
> � � � barrier to litigation, namely a rule authorizing a lien action to
> � � � be filed on behalf of Medicare only after a previous "judgment",
> � � � that is to say, only after the success of an earlier lawsuit (by
> � � � the injured party) establishing responsibility for the injury.
> � � * Language on p. 715 would double damages in cases of "intentional
> � � � tort or other intentional wrongdoing".
> � � * P. 716 specifies that "any person" may bring the action, that is,
> � � � it need not be a lawyer representing the injured person or any
> � � � other injured person.
> � � * P. 717: the bounty would be a rich one, 30 percent plus expenses.
> � � � P. 719 provides that even if the federal government itself
> � � � intervenes and insists on taking over the lawsuit, the
> � � � bounty-hunter would still get a minimum of 20 percent, perhaps as
> � � � reward for winning the race to the courthouse. No one other than
> � � � the federal government could oust the first-to-file lawyer from
> � � � control of the action, so other private lawyers who lost the race
> � � � to the courthouse would be out of luck. Page 720 specifies that
> � � � the suit may be settled "notwithstanding the objections of the
> � � � United States" --- that is, the objections of the entity on whose
> � � � behalf it was supposedly filed --- if a court so agrees.
> � � * Medicare would have to cooperate with the private lawyers, whether
> � � � or not the government joined or approved of the action, by handing
> � � � over various documents useful to them.
>
> For the moment, at least, the bullet seems to have been dodged. Some
> Republicans on the committee spotted the issue and raised strong
> protests, and by the end of the day an agreement had been reached with
> Democratic managers to withdraw the provision. That still provides no
> guarantee that it will not rear its head later in the process at some
> stage that proponents judge more favorable to their designs.
>
> The idea being promoted here is an atrocious one. Even when it comes to
> garden-variety torts, there are many entirely legitimate reasons why
> federal managers might not decide to pursue Medicare liens from every
> possible defendant. To take only one example, they might have scruples
> about suing peripheral defendants who might be made to cough up
> settlement money to avoid the costs of litigation but against whom
> liability was doubtful. Freelance private lawyers would be free to sue
> everyone in sight and employ the most hardball tactics along the way. If
> the language about epidemiological and statistical evidence is indeed
> meant to pave the way for future suits against liquor, gun or
> cheeseburger purveyors, it represents a stealth attempt to restore via
> fine print a lawyerly dream that the courts have almost uniformly
> rejected over the past decade, as well as personally enrich lawyers with
> fees that could soar beyond even those of the scandalous
> tobacco-Medicaid litigation. Who in Congress slipped this language in,
> anyway --- and on whose behalf?
>
> Incidentally, this is not the first time the idea of
> Medicare-lien/"secondary payer" qui tam has been given an outing. In
> 2006 the famous Erin Brockovich lent her name and efforts to lawsuits
> filed by Wilkes & McHugh and another law firm pursuing the highly
> adventurous theory that a qui tam right to sue over tort-induced
> Medicare overpayments already exists, at least against hospitals. This
> campaign fared extremely poorly in court (see our earlier coverage here
> <http://overlawyered.com/2006/06/erin-brockovich-takes-role-as-plainti...>,
> here
> <http://overlawyered.com/2006/11/update-brockovichs-medicare-billing-l...>,
> and here
> <http://overlawyered.com/2007/03/another-brockovich-medicare-suit-dism...>).
> Last year, in a case argued by Kenneth Connor
> <http://overlawyered.com/early-years/march-2001-archives-part-1/#0302c>
> for Wilkes & McHugh, the Sixth Circuit ruled that claims brought by
> Wilkes's client against dozens of hospitals were "utterly frivolous" and
> ordered counsel to show cause why sanctions should not be imposed for
> "unreasonable and vexatious" appeals (Stalley v. Methodist Healthcare
> <http://www.jonesday.com/files/News/021ad509-26f9-4de7-8637-0fa8911ffe...>,
> PDF; more <http://www.jonesday.com/news/news_detail.aspx?newsID=S1334>
> at Jones Day site). (*reposted with slight changes* and bumped from an
> earlier post this morning) (& welcome Popehat
> <http://www.popehat.com/2009/07/17/5411/>, Coyote
> <http://www.coyoteblog.com/coyote_blog/2009/07/tort-lawyer-full-employ...>,
> Weisenthal/Business Insider
> <http://www.businessinsider.com/massive-gift-to-trial-lawyers-found-in...>,
> Hemingway/NRO "Corner"
> <http://corner.nationalreview.com/post/?q=ZjA3NmU4NDgyZjk3NGU5MDQ3NWRj...>,
> For What It's Worth
> <http://christopherfountain.wordpress.com/2009/07/17/did-jim-himes-rea...>,
> Blogs for Victory
> <http://blogsforvictory.com/2009/07/18/ezra-klein-provides-party-line-...>,
> TigerHawk
> <http://tigerhawk.blogspot.com/2009/07/health-care-reform-bonus.html>,
> The Agitator
> <http://www.theagitator.com/2009/07/18/saturday-linksopen-thread-15/>,
> Colossus of Rhodey <http://colossus.mu.nu/archives/289833.php> readers).
>
> � � * Share/Save/Bookmark
> � � � 
> <http://www.addtoany.com/share_save?linkurl=http%3A%2F%2Foverlawyered....>
>
> � � � � Related posts
>
> � � * "Erin Brockovich Takes Role as Plaintiff in Medicare Suits"
> � � � 
> <http://overlawyered.com/2006/06/erin-brockovich-takes-role-as-plainti...>
> � � � (2)
> � � * Update: "Brockovich's Medicare-billing lawsuits tossed"
> � � � 
> <http://overlawyered.com/2006/11/update-brockovichs-medicare-billing-l...>
> � � � (0)
> � � * Another Brockovich Medicare suit dismissed
> � � � 
> <http://overlawyered.com/2007/03/another-brockovich-medicare-suit-dism...>
> � � � (2)
> � � * Wilkes & McHugh sued over alleged Tenn. fee grab
> � � � 
> <http://overlawyered.com/2007/02/wilkes-mchugh-sued-over-alleged-tenn-...>
> � � � (0)
> � � * White Coat Rants on "never events"
> � � � <http://overlawyered.com/2008/08/white-coat-rants-on-never-events/>
> � � � (14)
>
> Tagged as: Erin Brockovich
> <http://overlawyered.com/tag/erin-brockovich/>, Medicare
> <http://overlawyered.com/tag/medicare/>, qui tam
> <http://overlawyered.com/tag/qui-tam/>, Wilkes & McHugh
> <http://overlawyered.com/tag/wilkes-mchugh/>
>
> { 5 trackbacks }
>
> PointOfLaw Forum
> <http://www.pointoflaw.com/archives/2009/07/bountyhunters-p.php>
> � � 07.17.09 at 11:39 am
> | Popehat <http://www.popehat.com/2009/07/17/5411/>
> � � 07.17.09 at 11:54 am
> The Colossus of Rhodey <http://colossus.mu.nu/archives/289833.php>
> � � 07.18.09 at 10:12 am
> Republicans stop (for now) Dems offering of audacious and far-reaching
> trial lawyer power grabs in Health Care Bill. <http://caagenda.com/?p=71201>
> � � 07.18.09 at 6:50 pm
> Tort reform? � A Priori Concepts
> <http://jeffreysykes.wordpress.com/2009/07/18/tort-reform/>
> � � 07.18.09 at 7:51 pm
>
> { 13 comments... read them below or add one
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
>
> }
>
> 1
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Max Kennerly
> <http://www.litigationandtrial.com/2009/01/articles/the-law/for-people...>
> 07.17.09 at 12:59 pm
>
> � � Why, exactly, should the taxpayer instead of the tortfeasor be on
> � � the hook for medical costs due to the tortfeasor's conduct? Your
> � � objection is the essence of socialism: that society as a whole,
> � � rather than the responsible individuals, should bear the cost of the
> � � individual's conduct.
>
> � � As a practical matter, the Centers for Medicare & Medicaid Services
> � � (CMS) has nowhere near the resource to find and file these lawsuits,
> � � much like how the DoJ has nowhere near the resources to root out and
> � � litigate every fraudulent claim. So why not authorize, at the very
> � � least, the injured party to serve as realtor and expend their time
> � � and energy to recover damages on behalf of the taxpayer?
>
> 2
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Ken <http://www.popehat.com> 07.17.09 at 1:15 pm
>
> � � Max, by "the injured party" do you mean the person who received the
> � � Medicare treatment?
>
> � � My answer to your question, by the way, is that a qui tam approach
> � � --- particularly as unrestrained by the terms described in this post
> � � --- is a hideously inefficient and unfair system of attempting to
> � � assign actual legal responsibility. Thanks to the utter lack of
> � � serious barriers to or consequences for filing meritless suits, it
> � � mostly serves as a mechanism to transfer money to lawyers.
>
> 3
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Max Kennerly <http://www.litigationandtrial.com/> 07.17.09 at 1:59 pm
>
> � � I do indeed mean the person who received the treatment and then
> � � brought the suit against the tortfeasor. Such would then sharply
> � � limit 'relator' status to those in the best position to know the
> � � extent of such medical expenses and the liability of the defendant.
> � � Indeed, if drafted correctly, such a procedure would allow for
> � � /both/ the injury suit and the medical costs suit to proceed
> � � side-by-side and get neatly wrapped up together at time of verdict
> � � or settlement.
>
> � � Let me point out that for years state governments have been imposing
> � � liens on personal injury settlements and verdicts, despite
> � � Medicare's own anti-lien provisions. (There's currently litigation
> � � over this issue.) These are, again, costs borne by society (and
> � � attempted to be recouped against the injured party) due to someone
> � � else's malfeasance.
>
> � � I'd like to hear what system you have in mind that's more efficient
> � � and fair than the qui tam approach, which has done a remarkable job
> � � of both outsourcing work to private parties and of encouraging
> � � whistleblowing by persons aware of false claims. Do you think a
> � � large government bureaucracy should be established to recover these
> � � sums? How would that be "efficient" or "fair?" They would barely
> � � have any information on where to start, much less the resources to
> � � pursue these costs.
>
> 4
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Robert 07.17.09 at 6:54 pm
>
> � � Is the Thursday morning version of the bill available online?
>
> 5
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Walter Olson 07.17.09 at 7:13 pm
>
> � � I don't have the means to post PDFs. I am happy to send along the
> � � bill to someone who does (it's a big file, as can be imagined), but
> � � it's likely that someone has already posted it, so finding a URL for
> � � that would save the trouble.
>
> 6
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Georg Felis <http://georgfelis.blogspot.com> 07.18.09 at 12:09 am
>
> � � So, unlike what Max thinks, if this monster had blundered thru to
> � � become law, the *first* lawyer to file on behalf of the legions of
> � � diabetes sufferers blaming the manufacturer of Corn Sweeteners for
> � � their condition could possibly be in line to collect fees that the
> � � tobacco lawyers could only dream about, right? Then the suits
> � � against the oil companies for diesel particles in the atmosphere
> � � causing asthma, fast food companies for fatty foods, and so on ad
> � � nausum. Ick.
> � � Keep up the good work, and keep stomping these turkeys.
>
> � � If Bob is injured, and sues, and collects, thats law.
> � � If Bob is injured, and somebody he has never seen in his life sues
> � � and collects for him, and sends the money collected to somebody else
> � � Bob has never heard of, then that's a travesty.
>
> 7
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Max Kennerly <http://www.litigationandtrial.com> 07.18.09 at 9:57 am
>
> � � Georg -- that's an objection solely to who should have standing, one
> � � I sympathize with. Qui tam 'relator' standing is sharply limited to
> � � actual whistleblowers, and there's good reason to limit standing
> � � here as well.
>
> � � So why not permit Bob to bring the suit? Bob was the one injured and
> � � treated, the one who knows the details about the liability and
> � � costs, the one who was forced to utilize the public services due to
> � � someone else's malfeasance.
>
> 8
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Paul W Dennis 07.18.09 at 10:31 am
>
> � � It would seem to me one way to control any sort of qui tam adventure
> � � would be to make it subject to a strict "loser pays" rule. If one of
> � � these little adventures misfires (probably by chasing a non-culpable
> � � deep pocket) let them make the wrongly pursued target pocket deeper
> � � by assessing all fees and costs plus penalties and interest and
> � � suspend the offenders right to litigate until the judgment is paid
>
> � � If the problem for Medicare is resources, then staff up medicare
> � � properly or forget about it. The only honest and ethical bounty
> � � hunter ever was Palladin (in Have Gun, Will Travel) and he was a
> � � ficticious character . Most are "Dog -- The Bounty Hunter" and
> � � allowing them to serve as the enforcer of Medicare liens is beyond
> � � repulsive
>
> � � p.s -- while I disagree with much of what Kennerly says, he does
> � � have a very interesting blog
>
> 9
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Chris Gullen <http://blog.gullenlaw.com/> 07.18.09 at 11:27 am
>
> � � Personal injury practitioners see many cases in which Medicare (i.e.
> � � taxpayers) has paid for medical care of injured parties whose
> � � treatment should have been paid by existing health, workers'
> � � compensation or other insurance policies or self-insured plans.
> � � Likewise there are many cases in which Medicare has paid for
> � � treatment of injuries for which a tortfeasor is eventually found to
> � � have been responsible.
>
> � � Existing federal law (Medicare Secondary Payer statute) requires
> � � those primary insurance/self-insurance plans and responsible
> � � tortfeasors to reimburse Medicare once it is established that they
> � � did owe payment for the treatment, but the reality is that
> � � reimbursement is often not made.
>
> � � The MSP statute currently provides for a private right of action
> � � (not limited to the Medicare beneficiary) against the primary payer
> � � to recover twice the amount paid out by Medicare and, according to
> � � the 1st Circuit at least, the party suing for and recovering the
> � � double damages does not have to share the bounty with Uncle Sam.
>
> � � With the current double damages right of action on the books, is
> � � there a need for a new qui tam cause of action?
>
> 10
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Jeff Hall <http://createdthings.blogspot.com/> 07.18.09 at 6:05 pm
>
> � � The worst part of this idea isn't that it is going to cost the
> � � economy a bundle. In the process of transferring money from
> � � defendants to lawyers, these qui tam schemes would force thousands
> � � of old and sick people to spend a lot of time in court and giving
> � � depositions.
>
> 11
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Meredith 07.19.09 at 4:59 pm
>
> � � "Who in Congress slipped this language in, anyway --- and on whose
> � � behalf?"
>
> � � Anyone checked Chris Dodd's whereabouts when it got slipped in?
> � � Chris Dodd + stimulus legislation = AIG Bonuses
> � � Chris Dodd + his housing bill = Payment Card and Third Party Network
> � � Information Reporting
>
> 12
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> Max 07.20.09 at 1:51 am
>
> � � If we're going to treat the government's right to sue as a profit
> � � center, wouldn't the most efficient approach be to auction it off?
> � � Then you wouldn't have a wasteful "race".
>
> 13
> <http://overlawyered.com/2009/07/medicare-qui-tam-a-health-care-bill-s...>
> LexisTexas 07.20.09 at 2:03 am
>
> � � / [S]uch a procedure would allow for both the injury suit and the
> � � medical costs suit to proceed side-by-side and get neatly wrapped up
> � � together at time of verdict or settlement./
>
> � � /But medical expenses would have been included as actual damages in
> � � Plaintiff's original suit, so, presumably this provision would apply
> � � where Defendant had plead damages only for non-medical, or where
> � � they were not specified.
> � � I agree that qui tam is a fair, even surprisingly market-oriented,
> � � approach to reimbursement of Medicare debts on behalf of the
> � � government (as opposed to expecting government attorneys to do it).
> � � So, the bill's only unique expansion is to allow private attorneys
> � � do the collection work.
> � � Fine, but they would still be limited to collecting from the
> � � successful Plaintiff--collateral estoppel and one-judgment rule
> � � would preclude Defendant or even his insuror from paying twice.
> � � As far as attempting to expand liability by statistical analysis out
> � � to entire industries---good luck. No amount of Federal legislation
> � � is going to change the meaning of "proximate" cause./
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