Progressive Insurance to Face Medicare Secondary Payer Allegations

The onus is on an automobile insurer to determine whether an insured driver is a Medicare or Medicaid beneficiary before billing the government for primary coverage under a “health first” insurance policy, a federal court ruled March 1 (Negron v. Progressive Cas. Ins. Co., 2016 BL 60464, D.N.J., 1:14-cv-00577-NLH-KMW, 3/1/16).

The U.S. District Court for the District of New Jersey denied a motion from Progressive Casualty Insurance Co. to dismiss a whistle-blower’s False Claims Act (FCA) lawsuit amid allegations that Progressive’s sales and billing practices resulted in providers submitting false Medicare and Medicaid claims.

The court said ...