District Court for HI Rules a MAP Entity Can Sue for Double Damages

November 5, 2026 / 11 min read

In a new Medicare Advantage update, the United States District Court for Hawaii in Alpha Thirteen v. OAHU Transit Services, Inc., 2026 WL 3269908 (D. Hawaii, October 30, 2026) has ruled that the assignee of a Medicare Advantage Plan (MAP) “downstream entity”^[1]can sue for double damages under the Medicare Secondary Payer (MSP) statute’s private cause of action (PCA) provision.^[2]

Summary

In this case, an individual (noted as “C.G.”) was injured while exiting an Oahu Transit Services (OTS) bus. C.G. was enrolled in a UnitedHealthcare Medicare Advantage Plan (MAP). MDX Hawaii, a downstream entity of UnitedHealthcare, allegedly issued conditional payments to C.G.’s medical providers in the amount of $8,907.71 for accident-related medical treatment. The court described downstream entities, generally, as “local entities [that MAPs occasionally contract with] that pay for beneficiaries’ care.”^[3]

C.G. and OTS eventually settled, but this settlement did not resolve MDX Hawaii’s reimbursement claim. MDX Hawaii then assigned its recovery rights to Alpha Thirteen, which, in turn, sued OTS seeking reimbursement of MDX Hawaii’s payments, including double damages under the MSP’s PCA statute. OTS moved to dismiss Alpha Thirteen’s action.

In denying OTS’s motion to dismiss, the court ruled, in part, that Alpha Thirteen, as the assignee of a MAP downstream entity, had standing to sue OTS under the MSP’s PCA statute. As part of its decision, the court noted that the U.S. Ninth Circuit Court of Appeals (which, in part, has jurisdiction over federal cases originating from Hawaii)^[4]had not yet directly addressed this issue. Thus, noting no precedent from the Ninth Circuit, the court found persuasive prior rulings from the Second Circuit in Aetna Life Insurance Company v. Big Y Foods, Inc., 52 F.4^th (2^nd Cir. 2022); the Third Circuit in In re Avandia, 685 F.3d 353 (3rd Cir. 2012); and Eleventh Circuit in Humana v. Western Heritage Insurance Co., 832 F.3d 1229 (11th Cir. 2016) which all found that MAPs could sue under the MSP’s PCA provision.^[5]

While the court agreed with these prior decisions, it acknowledged that the Circuit Courts in the above cases technically only addressed the issue regarding Medicare Advantage Plans themselves (and not downstream entities). However, the court found no reason why the PCA statute would not also apply to downstream entities stating, in part, that there was “no reason to treat downstream entities differently from [MAPs], especially if downstream entities ultimately bear the financial responsibility for Medicare beneficiaries’ medical costs.”^[6]Thus, based on this decision, the court is allowing Alpha Thirteen’s case to proceed.

Going forward, we will need to see if the court ultimately finds OTS liable for double damages based on the underlying facts, and whether OTS may decide to appeal the court’s ruling to the Ninth Circuit Court of Appeals. In the interim, insurers with Hawaii claims should note this new decision and evaluate their current MAP protocols to avoid potential MAP PCA claims. Verisk will continue to monitor this case and provide updates as warranted. Also, keep in mind that Verisk can assist insurers with addressing MAP recovery claims.

For those interested in a more detailed analysis, the following is presented:

Facts

In February 2023, an individual noted as “C.G.” was injured while exiting an Oahu Transit Services (OTS) bus.^[7]C.G. filed a personal injury suit against OTS seeking, in part, medical expenses. C.G. was enrolled in a UnitedHealthcare Medicare Advantage Plan at the time of this incident. MDX Hawaii, a downstream entity of UnitedHealthcare, allegedly issued conditional payments to C.G.’s medical providers in the amount of $8,907.71 for accident-related medical treatment.^[8]

C.G. and OTS eventually settled, but MDX Hawaii’s claim for reimbursement of the $8,907.71 was not resolved.^[9] MDX Hawaii did not file an action against OTS for reimbursement. Rather, OTS assigned its recovery rights to Alpha Thirteen, which, in turn, filed this action against OTS seeking double damages under the MSP’s private cause of action (PCA) statute.

The court dismissed Alpha Thirteen’s First Amended Complaint

Alpha Thirteen initially suffered a setback when the court dismissed its First Amended Complaint (FAC), finding, in general, that the FAC “’[did] not contain any facts tying C.G.’s alleged injury at the hand of OTS to MDX Hawaii’s ultimate assignment of its claims to Alpha Thirteen.’”^[10]In dismissing the FAC, the court explained, in general, that “’[t]o establish standing, a plaintiff must show (1) that it has suffered an injury in fact, (2) that is fairly traceable to the challenged conduct of the defendant, and (3) is likely to be redressed by a favorable decision. [citation omitted]. Importantly, even an assignee of a claim can establish standing to assert the injury suffered by the assignor. To do so, the assignee must show that ‘(1) its ultimate assignor suffered an injury-in-fact, and (2) the assignor’s claim arising from that injury was validly assigned.’ [citation omitted].^[11]As such, as part of the court’s order dismissing the FAC, the court explained, in part, that "Alpha Thirteen’s obligation is to allege facts sufficient to show that MDX Hawaii would have had standing in its own right, and that it ‘validly assigned its right to recover on the claims arising out of that injury.’”^[12]

The court found that Alpha Thirteen’s Second Amended Complaint adequately established standing for it to sue OTS

Following the court’s dismissal of its FAC, Alpha Thirteen filed a Second Amended Complaint (SAC), which is the subject of this decision. OTS filed a motion to dismiss the SAC alleging that Alpha Thirteen lacked standing to sue arguing that Alpha Thirteen failed to state a claim for relief under the MSP’s PCA statute.^[13]

However, this time around, the court found that Alpha Thirteen’s SAC adequately established standing to sue. In general, the court found that the SAC showed that that MDX Hawaii would have had the right to sue on its own, alleged facts to establish that MDX Hawaii suffered an injury-in-fact when it made payments on behalf C.G., that these injuries were fairly traceable to OTS, and that the injury is redressable by a favorable decision through the requested compensation.^[14] Further, the court found that the SAC also sufficiently alleged that MDX Hawaii validly assigned its claim to Alpha Thirteen.^[15] Thus, the court denied OTS’s motion to dismiss the SAC.^[16]

The court ruled that Alpha Thirteen – as the assignee of a MAP downstream entity – could sue for double damages under the MSP’s PCA statute

After resolving the standing issue, the court turned its attention to whether Alpha Thirteen, as the assignee of a MAP downstream entity, could sue for double damages under the MSP’s PCA statute.

By point of reference, the PCA statute states: “There is established a private cause of action for damages (which shall be in an amount double the amount otherwise provided) in the case of a primary plan which fails to provide for primary payment (or appropriate reimbursement) in accordance with paragraphs (1) and (2)(A).” 42 U.S.C. 1395y(b)(3)(A).

OTS argued, in part, that the “text and structure” of PCA statute did not apply to MAPs or their downstream entities and that the PCA was inapplicable as MAPs have recovery rights under separate statutory provisions contained in the MAP statutes.^[17] However, the court disagreed.

As part of its analysis, the court noted that the question of whether the MSP’s PCA statute applies to MAPs, and their downstream entities, has not yet been directly addressed by the United States Ninth Circuit Court of Appeals (which has jurisdiction over federal cases originating from Hawaii).^[18]

However, the court noted that the Second Circuit in Aetna Life Insurance Company v. Big Y Foods, Inc., 52 F.4^th (2^nd Cir. 2022); the Third Circuit in In re Avandia, 685 F.3d 353 (3rd Cir. 2012); and Eleventh Circuit in Humana v. Western Heritage Insurance Co., 832 F.3d 1229 (11th Cir. 2016) all found that MAPs could sue under the MSP’s PCA provision.

Thus, noting no controlling precedent from the Ninth Circuit,^[19] the court found the above rulings from the Second, Third, and Eleventh Circuits persuasive stating as follows:

The court sees no reason to depart from the growing consensus among the courts of appeals. As the Second, Third, and Eleventh Circuits all have recognized, the text of § 1395y(b)(3)(A) is as broad as it is plain. On its face, the open-ended language does not preclude MAOs or downstream entities from asserting the double-damages cause of action. The statute instructs that it creates ‘a private cause of action for damages (which shall be in an amount double the amount otherwise provided) in the case of a primary plan which fails to provide for primary payment (or appropriate reimbursement) in accordance with paragraphs (1) and (2)(A).’ 42 U.S.C. § 1395y(b)(3)(A).

These paragraphs outline when an entity that covered the costs of medical services should be reimbursed for those payments. In particular, Paragraph (1) establishes requirements for primary group health plans. Id. § 1395y(b)(1). And Paragraph (2)(A) bars payment by Medicare when '(i) payment has been made, or can reasonably be expected to be made ... as required under paragraph (1), or (ii) payment has been made or can reasonably be expected to be made under a workmen’s compensation law or plan of the United States or a State or under an automobile or liability insurance policy or plan (including a self-insured plan) or under no fault insurance).' Id. § 1395y(b)(2)(A). Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *6.

From there, the court noted that it saw nothing in the PCA’s text that would preclude a MAP downstream entity from being able to sue under this provision stating:

Nothing in the statute suggests that [MAPs] and their downstream entities are precluded from the private right of action double-damages provision. Indeed, the provision may be one of the only ways for [MAPs] to seek recovery from a primary plan once it makes a conditional payment. MAO-MSO Recovery II, LLC v. Farmers Ins. Exch., 2022 WL 1690151, at *10 (C.D. Cal. May 25, 2022) (explaining that if a [MAP] makes ‘a conditional payment,’ it must rely on § 1395y(b)(3)(A) ‘to seek reimbursement from the primary payer who should have made payment in the first place (quoting MAO-MSO Recovery II, LLC v. State Farm Mut. Auto. Ins. Co., 994 F.3d 869, 872 (7th Cir. 2021)). Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *6.

While the court agreed with the rulings from the above noted Circuit Courts, it acknowledged that the courts in these cases technically only addressed the issue pertaining to MAPs. However, the court found no reason why downstream entities should be treated differently.

On this point, the court stated:

Granted, the cases decided by the Second, Third, and Eleventh Circuits concerned [MAPs] themselves as opposed to downstream entities. But the court sees no reason to treat downstream entities differently from [MAPs], especially if downstream entities ultimately bear the financial responsibility for Medicare beneficiaries’ medical costs … [t]he bottom line is that the MSP Act is best read as allowing any party—including a [MAP] or downstream entity—to invoke the double-damages cause of action if they have standing to sue. They might have standing because they paid for medical treatment. Or, as in this case, they might have standing because a party with standing validly assigned their claim. Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *6-*7.

Of note, while the court noted that Circuit Court rulings cited above only addressed the PCA question pertaining to Medicare Advantage Plans (and not downstream entities), per the author’s research, there is another Eleventh Circuit case, MSP Recovery Claims, Series LLC v. Ace American Insurance Company, et. al., 974 F.3d 1305 (11^th Cir. 2020) in which the Eleventh Circuit in that case ruled, in part, that MAP downstream entities could sue for double damages under the MSP’s PCA statute.

Based on the court’s analysis, the court denied OTS’s motion to dismiss thereby allowing Alpha Thirteen’s PCA claim to continue.

What’s Next?

Going forward, we will need to see if the court ultimately finds OTS liable for double damages based on the underlying facts, and whether OTS may decide to appeal the court’s ruling to the Ninth Circuit Court of Appeals. In the big picture, the United States District Court for Hawaii joins several other district courts that have similarly found that MAPs (and, in some cases, downstream and other MAP entities) can sue for double damages under the MSP statute.^[20]As we wait to see what happens next in this case, insurers with Hawaii claims should take note of this new decision and evaluate their current MAP protocols to avoid potential MAP PCA claims. Verisk will continue to monitor this case and provide updates as warranted.

How Verisk can help

Keep in mind that Verisk can help you address MAP recovery claims and help you build MAP best practices on either an ad hoc (case by case) basis or through our programmatic CP Link service.

[1] The court described downstream entities, generally, as “local entities [that MAPs occasionally contract with] that pay for a beneficiaries’ care.” Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *2.

Of note, the United States District Court for Maryland in its recent decision in MAO-MSP Recovery II, LLC v. Government Employers Ins. Co., 2024 WL 2924063 (D. Maryland, June 10, 2024) provided a more detailed definition of a “downstream entity” (as well as a related entity known as a “first tier entity”) as follows:

As defined by CMS regulations, a ‘first tier entity’ is “any party that enters into a written arrangement, acceptable to CMS, with an [MAO] to provide administrative services or health care services for a Medicare eligible individual under the MA program,” and a “downstream entity” is ‘any party that enters into a written arrangement, acceptable to CMS, with persons or entities involved with the MA benefit, below the level of the arrangement between an [MAO] and a first tier entity.’ 42 C.F.R. § 422.2 Such entities can incur financial costs associated with making conditional payments or reimbursing MAOs for their conditional payments. See MSP Recovery Claims, Series LLC v. ACE Am. Ins. Co., 974 F.3d 1305, 1314 (11th Cir. 2020). The GEICO Defendants assert that any conditional payments made by such entities are made pursuant to contracts with MAOs, not with CMS, so these entities have no statutory remedy to seek recovery for those payments. The GEICO Defendants cite no authority for this argument other than a district court case that was later abrogated by the United States Court of Appeals for the Eleventh Circuit. (citations omitted). MAO-MSP Recovery II, LLC v. Government Employers Ins. Co., 2024 WL 2924063 (D. Maryland, June 10, 2024), at *9.

[2] The MSP’s private cause of action statute is codified at 42 U.S.C. 1395y(b)(3)(A) which states, in full, as follows: “There is established a private cause of action for damages (which shall be in an amount double the amount otherwise provided) in the case of a primary plan which fails to provide for primary payment (or appropriate reimbursement) in accordance with paragraphs (1) and (2)(A).” Id.

[3] Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *2. See also n. 1.

[4] The Ninth Circuit has jurisdiction over federal cases originating from Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Oregon, and Washington, along with the territories of Guam and the Northern Mariana Islands. See, https://www.ca9.uscourts.gov/

[5] By way of note, the 3rd Circuit has jurisdiction over federal cases originating in Delaware, New Jersey, Pennsylvania, and the U.S. Virgin Islands; the 11th Circuit has jurisdiction over federal cases originating in Alabama, Florida, and Georgia; while the Second Circuit has jurisdiction over federal cases originating in Connecticut, New York, and Vermont.

[6] Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *5.

[7] Id. at *2.

[8] Id.

[9] Id.

[10] Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *2, citing Dkt. No. 27, at PageID 767. On this point, the court stated in greater detail as follows: “The court dismissed Alpha Thirteen’s prior complaint—the First Amended Complaint, or ‘FAC’—for lack of jurisdiction. It reached that conclusion because the pleading “[did] not contain any facts tying C.G.’s alleged injury at the hand of OTS to MDX Hawaii’s ultimate assignment of its claims to Alpha Thirteen.” Dkt. No. 27, at PageID.767. In other words, what was missing was ‘any allegation that MDX Hawaii assigned the particular claims arising out of the injury caused by OTS to Alpha Thirteen.’ Id. While Alpha Thirteen pointed to a ‘Schedule 1’ as evidence that MDX Hawaii assigned its right to recover on claims paid out for C.G., that document did not provide a way “to discern which claims, if any, are related to injuries incurred as a result of C.G.’s bus accident, or indeed whether any Patient ID corresponds to C.G. at all.” Id. at PageID.768. Thus, as the court observed, “neither the First Amended Complaint nor Exhibit 1 alleges that any Patient ID listed on Schedule 1 is in fact C.G.” Id. On that ground, the court granted OTS’ motion to dismiss and did not address any of the other contentions OTS made in its motion to dismiss. Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *2.

[11] Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *2.

[12] Id. at *3.

[13] Id.

[14] Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *3. On these points, the court stated, in full, as follows: “Alpha Thirteen’s SAC has shown that MDX Hawaii would have had the right to sue on its own. First, the facts alleged in the SAC establish that MDX Hawaii suffered an injury-in-fact when it made payments on behalf of Medicare enrollee C.G. See Dkt. No. 28, at PageID.781–82; Dkt. No. 34, at PageID.1364–1483. Second, these injuries are fairly traceable to OTS. Unlike in the FAC, which the court previously determined lacked the “factual connective tissue” linking “C.G.’s alleged injury at the hands of OTS to MDX Hawaii’s ultimate assignment of its claims to Alpha Thirteen,” the SAC cures these defects. Dkt. No. 28, at PageID.783; Dkt. No. 25, at PageID.1486–88. In its SAC, Alpha Thirteen lists only entries related to the accident-related injuries that MDX Hawaii paid on behalf of C.G. Dkt. No. 28, at PageID.783; Dkt. No. 35, at PageID.1486-88. And third, the injury is redressable by a favorable decision through the requested compensation. Dkt. No. 28, at PageID.787. Thus, the court concludes that the facts alleged in the SAC adequately establish standing." Id.

[15] Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *4. Regarding the Hawaii MDX’s assignment to Alpha Thirteen as plead in the SAC, the court stated: “The SAC also sufficiently alleges that MDX Hawaii validly assigned its claim to Alpha Thirteen. The unredacted SAC identifies the alleged Assignor as ‘MDX Hawaii,’ the alleged Assignee as ‘Alpha Thirteen,’ and the date of the assignment. It also describes the essential terms of the assignment agreements, including that ‘Assignor hereby irrevocably and absolutely sells, assigns, grants, conveys, transfers, and sets over to Assignee ... all Legal Claims arising from or related to Assignor’s payment of the Identified Medical Claims.’ Dkt. No. 34, at PageID.1261. In light of these factual allegations in the SAC, the court concludes that Alpha Thirteen pleads sufficient facts giving rise to subject matter jurisdiction. Accord MAO-MSO Recovery II, LLC v. Farmers Ins. Exch., No. 17-cv-02559, 2018 WL 2106467, at *8 (C.D. Cal. May 7, 2018) (holding that pleadings were sufficient where they identified the alleged assignors, assignees, date of the assignments, and essential terms of the agreement).” Id.

[16] Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *4.

[17] As part of its argument, OTS contended that a narrow reading of the PCA statute was applicable given that MAPs are afforded a recovery right under a separate statutory provision, 42 U.S.C. 1395w-22(a)(4) under the MAP statutes. As such, OTS argued that because Congress has created a separate method for MAPs to seek recovery, it must not have authorized MAPs to also sue under the MSP’s PCA statute.

The court, however, rejected this argument based on the Ninth Circuit’s ruling in Parra v. Pacificare of Arizona, Inc. 715 F.3d 1146 (9^th Cir. 2013).

In this regard, the court stated: “One problem with OTS’s argument is that it clashes with Ninth Circuit precedent: to the extent a MAO-specific provision exists for recovering past payments, the Ninth Circuit has suggested that it does not lend itself to an independent cause of action. In Parra v. PacifiCare of Arizona, Inc., the Ninth Circuit held that while § 1395w-22(a)(4) ‘allows recovery from a primary plan that refuses to reimburse the MAO for payments made on behalf of a participant,’ it does not create a private right of action. (citation omitted). Instead, it ‘simply allows [a MAO] to provide via its contracts that its insurance is secondary to other available plans” and to bring a contracts claim to recoup those costs. (citations omitted) Hence, permitting MAOs to assert a double-damages cause of action under § 1395y(b)(3)(A) would not, as OTS argues, ‘substantially diminish the independent work performed by Congress’ separate Medicare Advantage provision.’ (citation omitted). In fact, excluding MAOs from availing themselves of § 1395y(b)(3)(A) would run contrary to regulations, which provide that MAOs “exercise the same rights to recover from a primary plan, entity, or individual that the Secretary exercises under the [Medicare Secondary Payer] regulations in subparts B through D of part 411 of this chapter.” 42 C.F.R. § 422.108(f).” Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *6.

Expanding on the above point, the court further noted that Ninth Circuit “referenc[ed] this very regulation to support its holding that the MAO statute § 1395w-22(a)(4) does not itself create a federal cause of action for MAOs. (citation omitted). But the court referenced that line in interpreting whether the MAO statute created a private right of action, not in interpreting whether the MSP Act’s enforcement provision § 1395y(b)(3)(A) could be asserted by MAOs. (citation omitted). The distinction, while fine, is significant. The former goes to whether a statute should be interpreted as creating a private cause of action; the latter, which is already recognized as a cause of action, goes to whether that cause of action is open to certain actors. And insofar as the Parra court’s statements could be construed to foreclose MAOs from the double-damages private cause of action, any ambiguity is removed by its clarification that it was not resolving whether § 1395y(b)(3)(A) ‘provided a MAO a private right of action against third-party tortfeasors for medical expenses advanced on behalf of plan participants.’” (citation omitted) Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *6.

[18] See also, n. 4.

[19] On this point, the court stated: “This issue is one of first impression in the Ninth Circuit, but all other circuits to have interpreted the statute—the Second, Third, and Eleventh Circuits—have rejected the position OTS advances here. [footnote omitted]. In In re Avandia Marketing, Sales Practices and Products Liability Litigation, the Third Circuit determined that ‘[t]he language of the MSP private cause of action is broad and unrestricted and therefore allows any private plaintiff with standing to bring an action.’ 685 F.3d 353, 367 (3d. Cir. 2012). The Eleventh Circuit relied on a similar reasoning, concluding that it saw ‘no basis to exclude MAOs from a broadly worded provision that enables a plaintiff to vindicate harm caused by a primary plan’s failure to meet its MSP primary payment or reimbursement obligations.’ Humana Med. Plan, Inc. v. Western Heritage Ins. Co., 832 F.3d 1229, 1238 (11th Cir. 2022). And the Second Circuit is in accord. Aetna Life Ins. Co. v. Big Y Foods, Inc., 52 F.4th 66, 73 (2d Cir. 2022) (agreeing with and quoting from the Third and Eleventh Circuits’ decisions and observing that the provision ‘provides no limitation on which private actors may sue a primary plan that fails to provide reimbursement’).” Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *5; see also, n. 17.

In addition to the above, the court noted that “[a]lthough the Ninth Circuit has not yet opined on whether the MSP Act allows MAOs and downstream entities to rely on the double-damages provision, it has interpreted the meaning of the provision in other contexts. In DaVita, Inc. v. Virginia Mason Memorial Hospital, the Ninth Circuit ruled on the question of whether § 1395y(b)(3)(A) ‘require[d] payment by Medicare as a prerequisite to suit.’ 981 F.3d 679, 692 (9th Cir. 2020). It held that it did not. But the Ninth Circuit left unanswered the question currently before this court, its holding is in no way inconsistent with the decisions of the Second, Third, and Eleventh Circuits that the statute extends the double-damages private cause of action remedy to MAOs. Alpha Thirteen v. OAHU Transit Services, Inc. 2026 WL 3269908 (D. Hawaii, October 30, 2026), at *7, n. 3.

[20] On this point, the following United States District courts have ruled that MAPs (and, in some cases, downstream or other MAP entities) can sue for “double damages:” California: MAO-MSO Recovery II, LLC v. Mercury Insurance, 2018 WL 3357493 (C.D. Calif. 2018); MAO-MSO Recovery II, LLC v. Farmers Insurance Exchange, 2018 WL 2106467 (C.D. Calif. 2018); Connecticut: Aetna v. Guerrera, 300 F.Supp.3d 367 (D. Conn 2018); Illinois: MAO-MSO Recovery II, LLC v. State Farm, 2018 WL 340021 (C.D. Ill. 2018); MSP Recovery Claims, Series 44 v. Zurich, 2023 WL 5227396 (N.D. Illinois 2023); Louisiana: Collins v. Wellcare Healthcare Plans, Inc., 73 F.Supp.3d 653 (E.D. La. 2014); Maryland: MAO-MSP Recovery II, LLC v. Government Employers Ins. Co., 2024 WL 2924063 (D. Maryland 2024); Massachusetts: MSP Recovery Claims Series LLC v. Plymouth Rock Assurance Corporation, 404 F.Supp.3d 470 (D. Massachusetts 2019); Ohio: MSP Recovery Claims, Series LLC v. Phoenix Insurance Company, 426 F.Supp. 3d 458 (N.D. Ohio, 2019); MSP Recovery Claims, Series LLC v. Grange Insurance Company, 2019 WL 6770729 (N.D. Ohio 2019); and MSP Recovery Claims, Series LLC v. Progressive Corporation, 2019 WL 5448356 (N.D. Ohio 2019); South Carolina: Humana Ins. Co. v. Bi-Lo, LLC, 2019 WL 4643582 (D. South Carolina 2019); Tennessee: Cariten Health Plan, Inc. v. Mid-Century Ins. Co., No.: 2015 WL 5449221(E.D. Tenn. 2015); Texas: Humana Ins. Co. v. Farmers Tex. Cnty. Mut. Ins. Co., 95 F.Supp.3d 983 (W.D. Tex. 2014) and Humana v. Shrader, 584 B.R. 658 (S.D. Tex. 2018); and Virginia: Humana Ins. Co. v. Paris Blank LLP, 187 F. Supp.3d 676 (E.D. Va. 2016).

The U.S. District Court for Hawaii Rules That a Medicare Advantage Plan Downstream Entity Can Sue for Double Damages

Summary

For those interested in a more detailed analysis, the following is presented:

What’s Next?

How Verisk can help