United States District Court, D. Massachusetts
MSP RECOVERY CLAIMS, SERIES LLC and SERIES 17-04-631, Plaintiffs,
PLYMOUTH ROCK ASSURANCE CORPORATION, INC., and THE PLYMOUTH ROCK COMPANY, INC., Defendants.
MEMORANDUM AND ORDER ON PLAINTIFFS' MOTION FOR
ALLISON D. BURROUGHS U.S. DISTRICT JUDGE
Recovery Claims, Series LLC and Series 17-04-631
(“Plaintiffs”) brought this putative class action
against Plymouth Rock Assurance Corporation, Inc. and
Plymouth Rock Company, Inc. (collectively “Plymouth
Rock”) under the Medicare Second Payer Act
(“MSPA”) as the assignee of a Medicare Advantage
Organization (“MAO”). Plymouth Rock moved to
dismiss the lawsuit and to strike the proposed class
allegations. [ECF Nos. 8, 11]. The Court denied Plymouth
Rock's motion to dismiss, [ECF No. 8], but granted the
motion to strike, [ECF No. 11]. [ECF No. 26
before the Court is Plaintiffs' Motion for
Reconsideration of the Order. [ECF No. 28]. For the reasons
set forth below, Plaintiffs' Motion for Reconsideration
[ECF No. 28] is DENIED.
filed this action on August 13, 2018. [ECF No. 1]. On
December 21, 2018, Plymouth Rock filed both its motion to
dismiss, [ECF No. 8], and its motion to strike the class
allegations, [ECF No. 11]. On July 18, 2019, the Court denied
the motion to dismiss, but granted the motion to strike.
See generally [Order]. Plaintiffs filed their motion
for reconsideration on August 15, 2019. [ECF No. 28].
Plymouth Rock opposed on August 29, 2019, [ECF No. 29], and
Plaintiffs responded on September 11, 2019, [ECF No. 32].
following facts are drawn from the Complaint and the
documents attached to it. [ECF No. 1 (“Complaint”
or “Compl.”)]. A more complete version of the
facts is provided in the Court's earlier Order. [Order at
bring this action as the assignee of MAO Fallon Community
Health Plan (“Fallon”). [Compl. ¶¶ 7,
14]. On April 12, 2012, an individual named A.C., who later
enrolled in a Medicare Advantage plan administered by Fallon,
was injured in an accident. [Id. ¶¶ 7-8].
Between April 16, 2012 and August 30, 2013, A.C. received
medical services for injuries stemming from the accident.
[Id. ¶ 9]. One of the medical providers
treating A.C. billed Fallon $8, 106.30. [Id. ¶
10]. Fallon paid $1, 782.02 to settle the charge.
subsequently sued the tortfeasor involved in the accident,
who was insured by Plymouth Rock. [Id. ¶¶
8, 11]. Plymouth Rock settled A.C.'s claim and reported
the settlement to the Centers for Medicare and Medicaid
Services. [Id. ¶ 11]. Consequently, Plymouth
Rock became the primary payer for A.C.'s medical expenses
arising from the accident. [Id.]. On June 19, 2019,
Fallon assigned all rights to recover conditional payments to
MSP Recovery, LLC, which subsequently assigned all of those
rights to Series 17-04-631, a designated series of MSP
Recovery, LLC. [ECF No. 1 at 53]. Plaintiffs claim that
Plymouth Rock was aware that it was obligated to reimburse
Fallon for the $1, 782.02 payment, but failed to pay. [Compl.
addition to the specific payment in A.C.'s case,
Plaintiffs proposed a putative class based on other alleged
claims that Plymouth had failed to pay. [Compl. ¶ 51].
Plaintiffs proposed a class action on behalf of:
All Medicare Advantage Organizations, or their assignees,
that provide benefits under Medicare Part C, in the United
States of America and its territories, which made payments
for a Medicare beneficiary's medical expenses where
(1) is the primary payer by virtue of having settled a claim
with Medicare beneficiary enrolled in a Medicare Advantage
(2) settled a dispute to pay for personal injuries with a
Medicare beneficiary enrolled in a Medicare Advantage plan;
(3) failed to reimburse Medicare Advantage Organizations, or
their assignees, the payments provided for medical items and
services related ...