Plaintiffs use Proprietary Algorithm, Leveraging ISO Data in Part, to Reach Preliminary $5M Settlement in MSP Class Action
Roy Franco
January 23, 2018

Previously, we blogged on the “System” created by MSP Recovery LLC to identify potential primary payers in Medicare Advantage Plan (MAO) conditional payment recovery claims.  The Plaintiff, MSP Recovery LLC, testified that they created this unique “System” using the following databases; ISO reports, state car crash databases, MAO claim data, and others.  MSP Recovery has now secured a preliminary $5M settlement in court papers (search case number: 2015-1946-CA 01) filed on January 12th.   The principals of MSP Recovery LLC, Frank Quesada and John Ruiz, take a victory lap in an article about this released today.

MSP Recovery LLC is now beyond procedural motions with this settlement.  The industry can expect more as District Court Judge Antonio Arzola gave co-lead counsel John Ruiz the green light to proceed with another primary payer, IDS Property Casualty Insurance Company by January 25th.  This is now the second class action and status can be found at MSPA Claims 1 v. IDS Property Casualty Insurance Company (Case No. 2015-27940-CA 01).

Primary Plans need to take action to protect themselves from these lawsuits.  It makes no sense that Plaintiffs have access to primary plan data through ISO.  This data was meant to reduce litigation, not be a catalyst for it.  MAOs are reaping benefits from the MSP private cause of action, and Courts need to take judicial notice that such plans do nothing to provide a method to help the industry identify their plans, like Medicare does through the Section 111 Query process.  Legislation is necessary to correct this imbalance.  Join MARC!