Erin Brockovich's lawsuit against Fresno-based Community Medical Centers cannot proceed as a qui tam action, a federal judge has ruled. Brockovich, the legal assistant whose life was portrayed in a movie, claimed the medical centers violated the Medicare secondary payer statute (MSP) by injuring Medicare beneficiaries and improperly billing Medicare for treatment of those injuries.
Under the MSP statute, a Medicare payment "may not be made . . . with respect to any item or service to the extent that payment has been made or can reasonably be expected to be made" under a primary plan. According to Brockovich, hospitals must reimburse Medicare for any medical service, treatment, or medication necessary to treat injuries they caused.
The court ruled that the MSP statute is not a qui tam statute because it does not expressly authorize a private citizen to sue on behalf of the government.
Additional details can be found in a March 29, 2007 article by CCH and a March 9, 2007 article in the Fresno Bee.