Litigation Under the Medicare Act Up

The latest available data from the federal courts show that during the first two months of FY 2019 litigation under the Medicare Act has been rising. This continues a trend. Filings during the last six months were up 41.8 percent over the comparable period a year ago, and are higher by 148.1 percent compared with five years ago.

The long term trend in Medicare Act civil filings for these matters going back five years is shown more clearly in Figure 1. The vertical bars in Figure 1 represent the number of civil filings of this type recorded each month. The superimposed line on the bars plots the six-month moving average so that natural fluctuations are smoothed out.

Figure 1. Medicare Act Civil Filings Over the Last Five Years
(Click for larger image)

According to the case-by-case court records analyzed by the Transactional Records Access Clearinghouse (TRAC) at Syracuse University, the government reported 51 new lawsuits filed under the Medicare Act during October and November 2018. Just over half (55%) of these filings have been between private parties. In another 39 percent, the federal government has been sued. The typical causes of action in both of these involve such matters as an adverse reimbursement review, or issues over eligibility, election and enrollment under the Medicare Act. Only in 6 percent of the lawsuits was the federal government the plaintiff seeking debt collection or reimbursement.

The Southern District of Florida (Miami) saw the highest number of suits thus far in FY 2019. It accounted for 20 out of the total of 51 suits filed across the country. In second place was the District of Columbia with 13 suits. In all filings in D.C., the federal government was being sued. No other district saw more than a few suits so far this fiscal year.

Each month, TRAC offers a free report focused on one area of civil litigation in the U.S. district courts. In addition, subscribers to the TRACFed data service can generate custom reports by district, office, nature of suit or federal jurisdiction via the TRAC Data Interpreter.