In 2012, the Third Circuit considered whether companies who provide insurance under Medicare Part C, known as Medicare Advance Organizations (“MAOs”), can seek reimbursement of medical expenses from pharmaceutical companies who settled with their insureds on litigation claims related to use of the pharmaceutical company’s drug. That’s a mouthful, but essentially the question was whether MAOs can create a whole other litigation related to a mass tort in which they seek reimbursement for covering the mass-tort plaintiffs’ injuries. The answer from the Third Circuit was that they can. See In re Avandia Marketing, Sales Practices and Products Liability Litig., 685 F.3d 353 (3d Cir. 2012). Not great. But then last month the district court in that same case considered whether those MAOs do this in a class action. If so, that could foster a lot of this litigation. This time, however, the answer was no. See In re Avandia Marketing, Sales Practices and Products Liability Litig., 2014 U.S. Dist. LEXIS 164510 (Nov. 24, 2014 E.D. Pa.). And given the factual background of this case, that answer is no surprise.
The underlying litigation was the Avandia mass tort. GlaxoSmithKline, the manufacturer, settled with thousands of plaintiffs and thereby became obligated under Medicare law to reimburse certain MAOs that had initially paid the medical costs of plaintiffs. That resulted, when applicable, in a lien on the settlement funds by MAOs. GSK set aside a percentage of the settlement funds to account for those liens. Id. at *14. GSK also agreed with many MAOs to enter into Private Lien Resolution Programs (“PLRPs”), which satisfied the MAO liens. Id. at *14. GSK did this with 56 MAOs, which covered the vast majority of Avandia plaintiffs. Id. at *5. It sought to enter into PLRPs with other MAOs, but had not done so with 94 others at the time the court was considering plaintiffs’ class certification motion. These other 94 MAOs covered only a small share of the Avandia plaintiffs. Id. There was some evidence that many, not all, of those MAOs were not interested in PLRPs or collecting on liens.Continue Reading Federal District Court in Pennsylvania Denies Class Treatment of Medicare Claims against Pharmaceutical Company That Settled Mass Tort Claims