medicare reimbursement claims after benson v. sebelius

Medicare Reimbursement Claims from Undifferentiated Settlements after Benson v. Sebelius


A recent decision by the United States District Court for the District of Columbia provides additional federal judicial insight on the relationship between a state’s wrongful death statute and the federal Medicare Secondary Payer (“MSP”) statute. In Benson v. Sebelius the Court found that the reimbursement amount collected by CMS in a wrongful death settlement was in accordance with the applicable laws regulating CMS’ reimbursement rights and the claimant was not denied due process. This decision supports Medicare’s reimbursement claim recovery process, which had been questioned and ruled upon under a different set of facts by the Eleventh Circuit’s decision in Bradley v. Sebelius.

This Practice Tip provides a synopsis of Benson v. Sebelius and describes the impact this decision will likely have on the MSP reimbursement process and tort settlements going forward.


Among the tips included in this pamphlet are:

  • What are the key takeaways from Benson v. Sebelius?
  • What are the implications of this decision on the MSP reimbursement process and tort settlements going forward?
  • What is the relationship between state wrongful death statutes and the federal MSP statute?

The Garretson Resolution Group continues to closely monitor how decisions such as Benson affect tort settlements and MSP reimbursement claim resolution. Please see our website at www.garretsongroup.com for additional whitepapers, articles and other practice tips related to claim resolution.