Qui Tam (Continued from page 28)
from re-litigating liability issues in any, subsequent action brought pursuant to the 2003 amendments if a monetary judg- ment has been obtained in the underlying action at trial, or a finding of compens- ability by an administrative agency which was never appealed. However, a settlement payment probably does not mean that the underlying action cannot be re-litigated. Qui tam federal actions brought on be- half of the United States by individuals are specifically designed to recover medi- cal expenses and would not be subject to state evidentiary rules barring evidence of paid medical bills. Rather, the issue in the federal action is did the wrongdoer have insurance, in what amount at the time of the tortuous conduct that caused the medical expenses and has payment of
money been made to the victim? Unlike ERISA actions seeking payment of unpaid medical bills, the private rem- edy available to Medicare beneficiaries and recipients provides for double the amount of the medical expenses. Furthermore, the private cause of action will be decided by a jury and not a federal judge. The federal action has no express stat- ute of limitations concerning when an appropriate action may be filed to recover medical bills paid by Medicare. One cir- cuit court of appeal22
has already applied
a six year statute of limitations based on the Federal False Claims Act. Further- more, the statute of limitations is not
22
Manning v. Utilities Ins. Co. Inc. 254 F. 3d. 387 (2nd
Cir. 2001), contra Brooks v. Blue
Cross and BlueShield of Florida, 1995 WL 931702 at *18 and *19 (S.D. Fla. 1995).
triggered until a liable third party makes a monetary payment. One circuit court of appeals23
has also held that the 2003
amendments were clarifying and not sub- stantives, and that would seem to open the door to actions filed prior to Decem- ber 8, 2003. As a result, arguments should be unsuccessful that the amendments are ex post facto as to actions involving medi- cal bills incurred prior to December 8, 2003. Instead, the only bar would be the statute of limitations. After twenty long years, Medicare ben- eficiaries and recipients may finally have an effective federal cause of action to maxi- mize their personal injury cases.
23
Brown v. Thompson, 374 F. 3d 254, 259-60 fn 7 (4th
Cir. 200); 301 (d) of the Legisla- tion, 117 Stat. 2222.
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