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Eleventh Circuit Affirms Final Summary Judgment in Favor of Tower Hill

Eleventh Circuit Affirms Final Summary Judgment in Favor of Tower Hill

Eleventh Circuit Holds 28 U.S.C. § 1658(a)’s Four-Year Catch-All Statute of Limitations Applies to Private Claims under the Medicare Secondary Payer Act and that Claims Accrue at the Time the Violation Occurred

Tallahassee, Fla., August 12, 2022 – The Court of Appeals for the Eleventh Circuit has affirmed final summary judgment granted in favor of Tower Hill Prime Insurance Company (“Tower Hill”) on statute of limitations grounds, in a case brought under the Medicare Secondary Payer Act (“MSP Act”). The court held Plaintiff’s cause of action accrued in 2012 when Plaintiff’s assignor, a Medicare Advantage Organization (“MAO”), paid its enrollee’s medical bills and thus became entitled to reimbursement from Tower Hill under the MSP Act. Because that action occurred more than four years before Plaintiff filed suit in 2018, the court concluded the suit was not timely under 28 U.S.C. § 1658(a)’s catch-all limitations period.

Litigants have struggled with the question of which limitations period applies because the MSP Act’s private cause of action is silent on the issue. The Eleventh Circuit held that 28 U.S.C. § 1658(a)’s four-year statute of limitations applies to Plaintiff’s claims because they were made possible by a post-1990 Congressional enactment, i.e., Medicare Part C, which created MAOs. There was also uncertainty as to when the applicable statute of limitations accrues. In its ruling, the court rejected Plaintiff’s argument that the discovery rule should apply, which would have commenced the limitations period when Plaintiff said it first learned about Tower Hill’s settlement with its assignor’s enrollee. Instead, the court applied the occurrence rule, concluding the limitations period began on the date the violation of Plaintiff’s legal right occurred.

RumbergerKirk attorneys Nicole Smith, Samantha Duke and Jeffrey Grosholz represent Tower Hill in the case.

This case also was covered by Law360 in “11th Circ. Says Medicare Reimbursement Suit Filed Too Late” on August 11, 2022. Read more