Medicare Eligibility Did Not Terminate Employers Maintenance And Cure Obligation
PETITION OF RJF INTERNATIONAL CORPORATION FOR EXONERATION FROM OR LIMITATION OF LIABILITY, CIVIL AND MARITIME
C.A. No. 01-588S
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF RHODE ISLAND
332 F. Supp. 2d 458; 2004 U.S. Dist. LEXIS 16146
August 10, 2004, Decided
PROCEDURAL POSTURE: Claimant was a young seaman who was injured on August 11, 2001 while working on petitioner vessel owner's vessel when it was docked in Newport, Rhode Island. Before the court was the vessel owner's motion to terminate maintenance and cure benefits. Intervenor-plaintiff was the United States.
OVERVIEW: The question presented was whether Medicare supplanted maintenance and cure as the payor of first resort when a seaman became Medicare eligible. The vessel owner contended that it no longer was obligated to provide the seaman with "cure" due to his entitlement to Medicare benefits. It attempted to bring Medicare under the umbrella of the general rule that, under the doctrine of maintenance and cure, a shipowner will not be required to pay for medical care that is furnished at no expense to the injured seaman. The dispute focused upon the period of time between the expiration of Medicare's 25 month waiting period (the point at which a seaman became eligible for Medicare), and the seaman's subsequent attainment of maximum medical recovery. This period of time would vary on a case-by-case basis, the court stated. The court concluded that, under the Medicare Secondary Payer (MSP) provisions and regulations promulgated thereunder, Medicare was barred from providing payments to eligible beneficiaries when a primary plan was obligated to cover the same medical expenses--in other words, Medicare had to be the secondary payor in those circumstances.
OUTCOME: The vessel owner's motion to terminate the seaman's maintenance and cure benefits because of his eligibility for Medicare was denied.
