Payment Matters: Sovereign Immunity Extended to Medicare Contractors

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Win or lose, one out of two clients ask this question after an ALJ hearing: Can we sue the contractors to recoup our legal and other costs? With the recent decision from the United States Court of Appeals for the Third Circuit, the routine negative response is now, unfortunately, set in stone. In Nichole Medical Equipment & Supply, Inc. v. TriCenturion, Inc. and NHIC Corp. (Case No. 11-2132) [PDF] issued on September 13, 2012, a DMEPOS supplier that consequently went out of business sued the Medicare contractor that conducted the audit and the Medicare contractor that recouped the overpayment...

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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