Medical Malpractice Copays

August 7th, 2018 by Rieders Travis in Medical Malpractice

Mulberry Square Elder Care and Rehabilitation Center v. Department of Human Services, 2018 Pa. Cmwlth. LEXIS 352 (July 26, 2018) Simpson, J.  Mulberry Square Elder Care and Rehabilitation Center (Nursing Facility) petitions for review from an order of the Secretary of the Department of Human Services (Department).  The Secretary affirmed the Bureau of Hearings and Appeals’ (BHA) order adopting the Administrative Law Judge’s (ALJ) recommendation denying relief and rejecting Nursing Facility’s billing practice.  Specifically, the Department disallowed Nursing Facility’s practice of recouping unpaid copayments from residents eligible for medical assistance by billing the Department for the copays as medical expenses.  The Department also concluded this practice constituted balance-billing prohibited by applicable law.  Nursing Facility argues the Department did not promulgate a regulation explicitly precluding its billing practice.  Discerning no error below, we affirm.

Attorney Cliff Rieders

Attorney Cliff RiedersCliff Rieders is a Nationally Board Certified Trial Lawyer practicing personal injury law. A large part of his practice involves multi-district litigation, including cases related to pharmaceuticals, vitamin supplements and medical devices. He is admitted in several state and federal courts, as well as the Supreme Court of the United States. Rieders is the past regional president of the Federal Bar Association and is a life member of the distinguished American Law Institute, which promulgates proposed rules adopted by many state courts. He is a past president of the Pennsylvania Association for Justice, formerly Pennsylvania Trial Lawyers Association. As a founder of the Pennsylvania Patient Safety Authority, he served on the Board for 15 years.

Not only has Rieders held many highly esteemed, leadership positions, he authored legislation related to the Patient Safety Authority and the Mcare Act, which governs medical and hospital liability actions in Pennsylvania. He authored texts upon which both practitioners and judges rely, including Pennsylvania Malpractice Laws and Forms, and Financial Responsibility Law Issues in Pennsylvania, the latter governing auto and truck collisions in Pennsylvania. In addition, he wrote several books on the practice of law in Pennsylvania regarding wrongful death and survivor actions, insurance bad faith, legal malpractice claims and worker rights, among others. Rieders also serves as a resource to practitioners as a regular speaker for Celesq, an arm of the world’s largest legal publisher, Thomson Reuters West Publishing.

As recognition of his wide range of contribution to his profession and of his dedication to protecting the rights of his clients, he received numerous awards, among them the George F. Douglas Amicus Curiae Award, the Milton D. Rosenberg Award, the B’nai B’rith Justice Award, and awards of recognition from the Pennsylvania Trial Lawyers. [ Attorney Bio ]



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