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Court narrows Medicare double-damages claims in comp disputes - Business Insurance Skip to content Register for free Search Search Log In Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Court narrows Medicare double-damages claims in comp disputes by Louise Esola Claims Disputes , Workers Comp Coverage , Workplace Safety Feb 4, 2026 A Michigan appellate court has vacated a trial court ruling that would have allowed a hospital system to pursue double damages under the federal Medicare Secondary Payer Act against a workers compensation insurer while a coverage dispute was still unresolved. In Bronson Healthcare Group, Inc. v. Conifer Insurance Company , the Michigan Court of Appeals held that a medical provider does not have a viable private cause of action under the MSPA unless and until it is demonstrated that the insurer had responsibility to pay and failed to do so in a timely manner. The dispute arose after a bartender at a Michigan fraternal organization suffered a hip injury in 2017. Bronson Healthcare provided treatment and billed Conifer, which denied coverage on the ground that the injured worker was acting as a volunteer rather than an employee at the time of the accident. Medicare made conditional payments for the care. While workers compensation proceedings over employment status were still pending, Bronson sued Conifer under the MSPA, seeking double damages for failure to reimburse Medicare. A trial court granted summary disposition to the provider, finding the insurer collaterally estopped from relitigating employee status after a magistrate ruled in favor of coverage. The appellate court reversed, concluding the lawsuit was premature. The panel held that when a workers compensation insurer has a good-faith basis to dispute coverage, the MSPA’s “demonstrated responsibility” requirement operates as a condition precedent to a private double-damages action. Until responsibility is established through a judgment or similar means, the insurer cannot be deemed to have failed to reimburse Medicare. Allowing MSPA claims to proceed during unresolved coverage disputes, the court warned, would improperly convert ordinary workers compensation disputes into federal penalty actions and could expose insurers to punitive damages simply for contesting liability. The case was vacated and remanded with instructions to dismiss without prejudice, leaving open the possibility of a future MSPA claim if responsibility to pay is ultimately established and reimbursement does not occur. Related News Iowa bill targets legal reimbursement to state from second-injury fund February 4, 2026 Chubb CEO: Market growing more competitive February 4, 2026 WTW’s net income rebounds from loss February 4, 2026 French authorities raid X, summon Musk, former CEO February 4, 2026 Munich Re launches pandemic consortium February 4, 2026 Howden enters Fiji insurance market February 4, 2026 Insurers pay out $65M for Hong Kong apartment fire February 4, 2026 Supply chain disruptions continue hurting airlines February 4, 2026 Gallagher Reinsurance India appoints new CEO February 4, 2026 Facebook-f X-twitter Linkedin-in Business Insurance is a singular, authoritative news and information source for executives focused upon risk management, risk transfer and risk financing. 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