Fool Me Once, Shame on Me; Fool Me Again and You’re Gonna Pay for It: An Analysis of Medicare’s New Reporting Requirements for Primary Payers and the Stiff Penalties Associated with Noncompliance

Brent M. Timberlake *

Monica A. Stahly **

 

“Fool me once, shame on you; fool me . . . and you can‘t get fooled again.”*** —George W. Bush (2006)

 

July 30, 1965—that was the date on which two decades of debate over the national health insurance system that would come to be known as Medicare was signed into law as part of President Johnson‘s “Great Society” legislation. Since that time Medicare eligibility has expanded and the prospect of its insolvency continues to become more likely. In order to minimize unnecessary expenditures of Medicare funds, Medicare was statutorily deemed to have secondary liability in areas where primary insurers— including self-insurers, liability insurers, group health plans, and workers‘ compensation insurers—have an obligation to pay for Medicare recipients‘ medical care.

 

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*Associate, Troutman Sanders L.L.P., Richmond, Virginia. J.D., 2004, University of Richmond School of Law; B.A., 2001, Virginia Polytechnic Institute and State University

**J.D. Candidate, 2012, University of Richmond School of Law.

***godsroundtable, Bush “Fool Me Once . . .”, YOUTUBE (June 24, 2006), http:// www.youtube.com/watch?v=eKgPY1adc0A.