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Van Nortwick v Auto-Owners Insurance Company; (COA-UNP, 4/15/2003, RB #2371)


Michigan Court of Appeals; Docket #237310; Unpublished
Jansen, Kelly and Fort Hood; unanimous; per curiam
Official Michigan Reporter Citation: Not Applicable, Link to Opinion courthouse graphic

Not applicable

Medicare Benefits: Amount Owed by No-Fault Insurer in Medicare Reimbursement Cases

In unanimous unpublished per curiam opinion, the Court of Appeals held that when a health care provider accepts payment from Medicare as a full and final payment of the costs incurred for an accident victim’s hospitalization, and the provider closes its file on the matter, and where the victim’s no-fault insurer reimburses Medicare for the amount it paid for the hospitalization, the accident victim cannot recover, from the no-fault insurer, the difference between what Medicare paid the provider and what the provider originally charged. In this case, the plaintiff was injured in a motor vehicle accident and was billed $225,580 by the hospital for medical treatment. The hospital submitted its bill to Medicare and received $100,259.47, which it accepted as payment in full for its services. Plaintiff’s no-fault insurer subsequently reimbursed Medicare for that amount. The trial court found that plaintiff had incurred the expense stated in the hospital bill and granted plaintiff judgment for the difference between the billed amount and the amount paid by Medicare. In reversing, the Court of Appeals stated, “Here, defendant submitted an affidavit from the health care provider indicating that it accepted the Medicare payment as full and final payment of the costs incurred for plaintiff’s hospitalization, and it had closed its file on the matter. Where the health care provider accepted the Medicare payment as payment in full, plaintiff had no additional liability and incurred no other expenses.”

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