American Trading Co. v. L.,

L-9511-93 (N.J. Super. Ct. Middlesex County filed Oct. 12, 1995). ; Clearinghouse Number: 51166

Description

Medicaid Recipient Whose Claim Was Denied Argues That State Law Bars Hospital’s Assignee from Collecting Payment from Her

Abstract

Defendant Medicaid recipient has moved for summary judgment in this collection action. Plaintiff, as assignee of a hospital where defendant received medical services, seeks to recover payment for defendant’s gallbladder operation. Medicaid denied the hospital’s claim for payment because a second opinion had not been obtained before surgery. After Medicaid’s denial, plaintiff sought payment from defendant, who argues that plaintiff is prohibited under state law from recovering reimbursement from a Medicaid patient for services rendered. Defendant asserts that she was not aware of the second-opinion requirement, nor was she made aware of it; moreover, because the surgery was performed on an emergency basis, obtaining a second opinion, if required, was clearly impossible.

Additional Information

Attorney Information
Defendant represented by Russell Gale, Middlesex County Legal Services, 78 New St., 3d Floor, New Brunswick, NJ 08901-2584, (908) 249-7600.
Docket Date
1995-10-12 00:00:00+00:00