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U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages” – ruling affirms the district court’s award of double damages against insurer

In a major Medicare secondary payer (MSP) development, the U.S. Circuit Court of Appeals for the Second Circuit in Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022) has ruled, in part, that Medicare Advantage Plans (MAPs) can sue primary payers1 for “double damages” under the MSP’s private cause of action (PCA) statute.2 The Second Circuit has jurisdiction over claims originating from the U.S. District Courts for Connecticut, New York, and Vermont.3

Treasury Compliance

As part of this ruling, the Second Circuit affirmed a prior Connecticut district court decision which, in part, levied double damages against defendant Big Y Foods under the MSP’s PCA provision for its failure to reimburse MAP payments in relation to a personal injury settlement. 

In the bigger picture, the Second Circuit now joins the U.S. Circuit Court of Appeals for the Third and Eleventh Circuits which had previously held that MAPs can sue primary payers for “double damages” under the PCA statute in In re Avandia, 685 F.3d 353 (3rd Cir. 2012) and Humana v. Western Heritage Insurance Co., 832 F.3d 1229 (11th Cir. 2016), respectively.4 It is also noted that several U.S. District Courts have allowed MAPs to pursue PCA claims.Going forward, it will be interesting to see to what extent this new decision may impact current efforts to repeal the PCA statute regarding non-group health plans per the Repair Abuses of MSP Payments Act (RAMP Act) currently pending in Congress.

The below provides a more in-depth overview of this decision – and how Verisk can help you build programs to address Medicare Advantage and other Medicare recovery claims – as follows:

Facts

In February 2015, Nellina Guerrera fell and sustained injuries in a Connecticut Big Y grocery store.  At the time of this incident, Ms. Guerrera was enrolled in a Medicare Advantage Plan offered through plaintiff Aetna Life Insurance Company (Aetna) which paid $9,854.16 for her accident-related medical care.  Ms. Guerrera brought a claim against Big Y.6

In September 2015, Aetna sent Big Y a letter asserting that it was owed $9,854.16 in reimbursement under the MSP and that failure to pay could result in double damages.7 While Big Y acknowledged Aetna’s claim, it refused to pay, arguing, in part, that “it did not believe, in good faith, that the law imposed any duty or legal obligation on the part of Big Y to satisfy Aetna’s demands for payment under the circumstances.”8 Further, Big Y argued that Guerrera’s own negligence was the proximate cause of her injuries.9

In September 2016, the parties settled for $30,000.10 As part of the settlement, Ms. Guerrera signed a settlement agreement that included a disclaimer from Big Y denying all responsibility for the accident and a general release of Big Y from liability.11 Further, the agreement states that “[Guerrera] understands that this withdrawal of action is the result of a doubtful and disputed claim and that liability is expressly denied [by Big Y]” and that the parties “acknowledge ... this agreement does not constitute any admission of fault by any party and cannot be used in any other proceeding as evidence of the same.”12

After the parties settled, Aetna continued to demand reimbursement for the $9,854.16, and Big Y continued to refuse to pay.13 This stalemate then led Aetna to file legal action on its recovery claim.

U.S. District Court for Connecticut rules for Aetna – levies “double damages” against Big Y

In April 2017, Aetna filed suit in the United States District Court for Connecticut against Big Y, Ms. Guerrera and her lawyers, seeking reimbursement under the MSP’s private cause of action statute.  This case then came before the district court twice. 

Very generally, in 2018 the district court in Aetna v. Guerrera, 2018 WL 132066 (D. Conn. March 13, 2018) denied Big Y’s motion to dismiss ruling, in part, that Big Y was a primary plan and that Medicare Advantage Plans (such as Aetna) could sue primary plans under the MSP’s private cause of action statute.  However, while the court found that Aetna had a viable PCA action against Big Y, the court, as outlined in our prior article, ultimately dismissed Aetna’s claim against Ms. Guerrera, the law firm, and the individual lawyers, finding that the MSP’s PCA provision applied only against primary payers, and that these parties were not primary payers under the MSP.

In 2020, the case came back before the district court in Aetna v. Guerrera, 2020 WL 4505570 (D. Conn. August 5, 2020) on Aetna’s motion for summary judgment.  In general, as part of the court’s review, the court rejected Big Y’s argument that it was not a primary plan based on the text of the MSP and relevant judicial precedent.14  Big Y also argued, in part, that since the settlement did not explicitly cover Ms. Guerrera’s medical expenses, it was not liable under the MSP.15 On this point, the court agreed with Big Y that “whether a settlement (or other post-litigation) payment was for medical expenses paid by an [MAP] may, under different circumstances, be a fact over which a genuine dispute exists.”16 However, the court ultimately found “where, as here, there is no dispute that the underlying litigation that was settled did, in fact, include a claim for the payment of medical expenses, and such claim was settled with the payment of monies in exchange for a release, the plaintiff has demonstrated that the alleged tortfeasor, here Big Y, is a primary plan under the MSP Act.”17

Accordingly, the Connecticut district court granted Aetna’s motion for summary judgment and awarded Aetna $19,708.32 (twice the amount of Aetna’s claimed payments).18 Big Y then appealed to the U.S. Circuit Court of Appeals for the Second Circuit.19

U.S. Second Circuit Court of Appeals affirms the district court’s rulings - Medicare Advantage Plans (MAPs) can sue insurers for “double damages” under the MSP’s private cause of action statute

On appeal, the 2nd Circuit framed the issue as follows: “The question before us is whether the MSP Act’s private cause of action permits [a MAP] such as Aetna to recover from a tortfeasor such as Big Y.”20 

The Second Circuit answered “yes” to this question noting, in part, that “[t]he Eleventh and Third Circuits have answered that question in the affirmative …  We agree with our sister circuits. After examining Big Y’s remaining arguments, we conclude that no genuine issue of material fact remains, and therefore affirm the order of the district court.”21

In support of this conclusion, the Second Circuit’s analysis can be broken down, generally, around the following points:

The MSP’s private cause of action statute allows MAPs to sue under this provision

The Second Circuit, agreeing with the Third and Eleventh Circuits, found that MAPs can sue insurers under the MSP’s PCA statute. The court started its analysis by first examining the text of the MSP’s PCA statute.  This provision, which is codified at 42 U.S.C. § 1395y(b)(3)(A), reads 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).” 

In looking at the statute’s text, the Second Circuit noted that “[o]n its face this provision is broad and open-ended … [and it] provides no limitation on which private actors may sue a primary plan that fails to provide reimbursement.”22 On this point, the court noted that “[a]s the Eleventh Circuit concluded, there is no basis to exclude [MAPs] 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.”23 Continuing, the court noted how Third Circuit similarly observed, “the [private cause of action] provision is broad and unambiguous, placing no limitations upon which private (i.e., nongovernmental) actors can bring suit for double damages when a primary plan fails to appropriately reimburse any secondary payer.”24

As part of its analysis, the Second Circuit rejected Big Y’s argument that  references to the “Secretary” and “Trust Fund” in 42 U.S.C. 1395y(2)(B)25 limited the PCA statute only to the government and not MAPs.26 However, the court rejected this argument noting that the PCA statute refers only to Paragraphs (1) and (2)(A), not (2)(B) and that “[a]ny limitation to the private cause of action must thus come from Paragraphs (1) and (2)(A), the paragraphs referenced by the private cause of action provision, and not (2)(B).”27 Further, the court noted that references to “subchapter” in (2)(A) referred to the Medicare Act as a whole and “does not operate to exclude [MAPs] from utilizing the [PCA statute.]”28

MAP’s “right to charge” provision is not a MAP’s only remedy

The Second Circuit also rejected Big Y’s argument that the “right to charge” provision under the MAP statutes provides MAPs with a remedy and, therefore, they do not need access to the PCA statute.  On this point, the court noted that under 42 U.S.C. § 1395w22(a)(4) MAPs have the right, in general, to “charge” a primary payer for reimbursement of provided services.29  While recognizing this statutory provision, the court noted that “nothing in the text indicates that this is the exclusive remedy.” (court’s emphasis).30

MAP recoveries help to achieve Congressional objectives and can help lower program costs

The Second Circuit rejected Big Y’s claim that reimbursement to MAPs serves to simply line the pockets of private entities noting, on the contrary, that MAP recoveries help lower beneficiary costs.31 On this point, the court referenced the Third Circuit’s observation in Avandia that “[w]hen [MAPs] “recover[ ] from primary payers, [and] [MAPs] save money, that savings results in additional benefits to enrollees not covered by traditional Medicare. Thus, ensuring that [MAPs] can recover from primary payers efficiently with a private cause of action for double damages does indeed advance the goals of the [Medicare Advantage] program.”32

In addition, the Second Circuit noted that a main objective of Congress in creating the MAP program was Congress’s desire “to spur innovation by sparking competition with traditional Medicare plans and that denying MAP recoveries this purpose would essentially be thwarted.”33 Expanding on this point the court stated: “As the Third Circuit noted in Avandia, ‘[i]t would be impossible for [MAPs] to stimulate innovation through competition if they began at a competitive disadvantage, and, as CMS has noted, [MAPs] compete best when they recover consistently from primary payers …. Congress intended to create a level playing field between [MAPs] and traditional Medicare plans, and blocking [MAPs] from utilizing the best route of recovery from primary payers would be at odds with such an intent.’”34

Further, the Second Circuit noted that Congress’s intent in this regard was “bolstered” by the recent passage of the PAID Act which the court viewed, in part, as “reflect[ing] Congressional awareness that [MAPs] increasingly use the private cause of action to seek reimbursement from settling parties. Instead of blocking such suits, Congress streamlined the reimbursement process and lowered operational costs by increasing information sharing.”35

Big Y is a primary plan and the settlement demonstrated Big Y’s “responsibility” under the MSP

Big Y argued that it did not have responsibility under the MSP since it made what it viewed as a nuisance settlement and the settlement included a general release from MS. Guerrera and a denial of responsibility by Big Y.  Big Y further argued that, since medical costs were never discussed explicitly in the settlement, the payment was not for medical services and thus cannot qualify for Medicare reimbursement because the statutory language requires that payment be made “for items or services included in [the] claim against the primary plan[.]”36

The Second Circuit, however, rejected these arguments.  The court noted that the district court had properly found that Big Y, as a self-insured entity, was a primary plan as that term is defined under the MSP37 and that under 42 U.S.C. § 1395y(b)(2)(A) “[a] primary plan’s responsibility [to reimburse] may be demonstrated by a judgment, a payment conditioned upon the recipient’s compromise, waiver, or release (whether or not there is a determination or admission of liability) of payment for items or services included in a claim against the primary plan or the primary plan’s insured, or by other means.” Id. § 1395y(b)(2)(B)(ii) (court’s emphasis).38

Accordingly, in rejecting Big Y’s position, the court, in part, stated: "Big Y’s argument is directly contradicted by the statute, which, as discussed above, states that responsibility may be demonstrated by a payment conditioned upon the recipient’s release “whether or not there is a determination or admission of liability[.]”… As the district court concluded, it is enough that “Guerrera’s claim against Big Y included a claim for her medical expenses and the settlement resolved all of her claims, which, of necessity, included the claim for medical expenses.”39   

Concluding this point, the court further stated: “Big Y does not dispute that Guerrera filed a claim against Big Y seeking compensation for the personal injuries that she sustained; that Big Y settled that claim with Guerrera, paying Guerrera $30,000; and that Big Y knew that Aetna was asserting a lien against Big Y for Aetna’s payment of Guerrera’s medical expenses. There is no dispute of material fact remaining, and Big Y is responsible for payment as a matter of law.”40

Based on the foregoing reasons, the Second Circuit affirmed the judgment of the Connecticut district court, which included a levy of “double damages” against the insurer for its failure to reimburse Aetna’s MAP recovery claim.

Claims Considerations

As noted above, the Second Circuit’s ruling in Aetna is the latest decision allowing MAPs to utilize the MSP’s private cause of action statute to sue insurers – and, in this case, double damages were awarded.  Significantly, the Second Circuit joins the Third and Eleventh Circuits, along with a growing number of U.S. District Courts, finding that the MSP’s PCA statute applies to MAPs giving these entities a powerful recourse as part of their recovery efforts.  See our State-by-State Guide to Medicare Advantage and the Courts resource.  In this regard, this decision underscores the importance of making sure that Medicare Advantage (as well as all other Medicare recovery claims) are addressed and resolved as part of the claim settlement.  From another angle, it will be interesting to see to what extent this new decision may impact current efforts to repeal the PCA statute regarding non-group health plans ​ as part of the Repair Abuses of MSP Payments Act (RAMP Act) currently pending in Congress. 

Building a Medicare Advantage Game Plan how we can help!

With Medicare Advantage recovery claims on the rise, and with more courts allowing MAPs to sue for double damages, it is critical that insurers have a Medicare Advantage game plan to proactively address these claims to avoid potential double damages liability. 

An important point to keep in mind is that the PAID Act now provides insurers with critical information regarding a claimant’s Medicare Advantage and Part D (RX drug) enrollment status which can be used as the starting points toward building a plan to proactively address both Medicare Advantage and Part D recovery claims – and this is where we can help!  We can help you take advantage of the PAID Act by contacting the identified Medicare Advantage and Part D plans to determine if they are asserting a recovery claim, and if so, help dispute and remove any inappropriate or unrelated claims.

Here are key services we offer to help you build holistic strategies to address Medicare Advantage, Part D, and other Medicare recovery claims:

  • CP Link PAID Act add-on: CP Link is our programmatic solution that automates Medicare conditional payment identification, dispute, and resolution directly from Section 111 data for holistic compliance.  With our new CP Link® PAID Act add-on component, insurers now have a programmatic approach to MAP and Part D compliance. Built on our reliable approach to traditional Medicare recovery claims, the CP Link add-on leverages both Section 111 reporting data and the new PAID Act data to ensure that any recovery claims alleged by MAPs or Part D plans are addressed. This optional add-on service to our  CP Link program can help you take control of Medicare Advantage and Part D recovery claims.
  • Medicare Advantage Resolution Service: We can also help you address Medicare Advantage recovery claims on a case-by-case basis through our Medicare Advantage Resolution service and any Part D recovery claims you may receive.
  • Other Services: In addition to Medicare Advantage and Part D claims, keep in mind that we have several services to help you address traditional Medicare (CMS) conditional payment claims, including CP Link, as well as our standard Medicare conditional payment and Treasury Claims services. In terms of results, our various Medicare recovery services have consistently delivered significant cost savings for our clients. For example, in 2020, we saved our clients approximately $150 million in conditional payment disputes and reduced 64% of conditional payment dispute submissions to zero dollars. Our CP Link solution saved our clients over $14 million in 2020 and approximately $12.6 million in 2021. Finally, we can also help you build practical claims protocols to address each of the Medicare compliance areas noted above and provide training for management and adjuster.

Questions?

Please do not hesitate to contact the author if you have any questions on this new case or if you would like to set-up a call to further discuss how we can help you address Medicare recovery claims to reduce costs, avoid “double damages,” and get claims settled!


    1. Under the MSP, the term “primary plan” is defined at 42 U.S.C. § 1395y(2)(A)(ii) as follows: In this subsection, the term “primary plan” means a group health plan or large group health plan, to the extent that clause (i) applies, and a workmen’s compensation law or plan, an automobile or liability insurance policy or plan (including a self-insured plan) or no fault insurance, to the extent that clause (ii) applies. An entity that engages in a business, trade, or profession shall be deemed to have a self-insured plan if it carries its own risk (whether by a failure to obtain insurance, or otherwise) in whole or in part. This term is also defined at 42 C.F.R. § 411.21 as follows: “Primary plan means, when used in the context in which Medicare is the secondary payer, a group health plan or large group health plan, a workers’ compensation law or plan, an automobile or liability insurance policy or plan (including a self-insured plan), or no-fault insurance.”
    2.  The MSP’s private cause of action section, codified at 42 U.S.C. § 1395y(b)(3)(A), states 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).”
    3. See, https://www.ca2.uscourts.gov/about_the_court.html
    4.  The 3rd Circuit has jurisdiction over federal cases originating in Delaware, New Jersey, Pennsylvania, and the U.S. Virgin Islands; while the 11th Judicial Circuit has jurisdiction over federal cases originating in Alabama, Florida, and Georgia.
    5.  The following United States District courts have ruled (or strongly indicated) that MAPs can sue claims payers for double damages: MAO-MSO Recovery II, LLC v. Mercury Insurance, 2018 WL 3357493 (C.D. Calif. May 23, 2018); MAO-MSO Recovery II, LLC v. Farmers Insurance Exchange, 2018 WL 2106467 (C.D. Calif. May 7, 2018); Aetna v. Guerrera, 300 F.Supp.3d 367 (D. Conn. March 13,2018); MAO-MSO Recovery II, LLC v. State Farm, 2018 WL 340021 (C.D. Ill. January 9, 2018); Collins v. Wellcare Healthcare Plans, Inc., 73 F.Supp.3d 653 (E.D. La. 2014); MSP Recovery Claims Series LLC v. Plymouth Rock Assurance Corporation, 2019 WL 3239277 (D. Massachusetts, July 18, 2019); MSP Recovery Claims, Series LLC v. Phoenix Insurance Company, 2019 WL 6770981 (N.D. Ohio, December 12, 2019); MSP Recovery Claims, Series LLC v. Grange Insurance Company, 2019 WL 6770729 (N.D. Ohio, December 12, 2019); MSP Recovery Claims, Series LLC v. Progressive Corporation, 2019 WL 5448356 (N.D. Ohio, September 17, 2019); Humana Ins. Co. v. Bi-Lo, LLC, 2019 WL 4643582 (D. South Carolina, September 24, 2019); Cariten Health Plan, Inc. v. Mid-Century Ins. Co., No.: 2015 WL 5449221(E.D. Tenn. 2015); Humana Ins. Co. v. Farmers Tex. Cnty. Mut. Ins. Co., 95 F.Supp.3d 983 (W.D. Tex. 2014); Humana v. Shrader, 584 B.R. 658 (S.D. Tex. March 16, 2018); Humana Ins. Co. v. Paris Blank LLP, 187 F. Supp.3d 676 (E.D. Va. 2016)
    6.  Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *3.
    7.  Id.
    8.  Id.
    9.  Id.
    10.  Id.
    11.  Id.
    12.  Id.
    13.  Id.
    14.  Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *4.
    15.  Id.
    16.  Id.
    17.  Id.
    18.  Id.
    19.  Id.
    20.  Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *1.
    21.  Id. at *1, citing, Humana Med. Plan Inc. v. W. Heritage Ins. Co., 832 F.3d 1229, 1238-40 (11th Cir. 2016); In re Avandia Mktg., Sales Practices & Prods. Liab. Litig., 685 F.3d 353, 359, 367 (3d Cir. 2012).
    22.  Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *5.
    23.  Id. at *5, citing Humana, 832 F.3d at 1238.
    24.  Id. at *5 citing In re Avandia, 685 F.3d at 359.  It is noted that William J. Nardini, Circuit Judge issued a concurring opinion which focused primarily on the majority’s interpretation that the text of the PCA statute itself afforded MAPs to sue for double damages.  While a complete analysis of Judge Nardini’s concurring opinion is beyond the scope of this article, in general, it is noted that Judge Nardini agreed that MAPs could sue under the PCA statute.  However, as Judge Nardini stated, he “would arrive at the same destination by a somewhat different path.”  Aetna Life Insurance Company, 2022 WL 14701256 (2nd Cir. October 26, 2022), at *8. On this point, from Judge Nardini’s view, unlike the majority, the text of the PCA statute was ambiguous with respect to which actors could potentially sue under its provisions.  To resolve this ambiguity Judge Nardini stated that he would look to the regulations promulgated by CMS which, from his view, provided the basis for MAPs to sue under the PCA stating "[t]hese regulations fit comfortably within the range of reasonable interpretations of the MSP Act, and so I would simply defer to the CMS regulations.” Id.  Judge Nardini referred to 42 C.F.R. 422.108(f) as one of the supporting regulations which he noted  provides that an “[MAO] will exercise the same rights to recover from a primary plan, entity, or individual that the Secretary exercises under the MSP regulations in subparts B through D of part 411 of this chapter.” Id. at *9.  Judge Nardini also referenced 42 C.F.R. 411.22(b) to further support Big Y’s obligation to reimburse MAP payments noting this regulation contain no language which could be interpreted as limiting its reimbursement provisions only to governmental entities. Id.  On these points, Judge Nardini further commented that “[f]or many of the reasons the majority relies on to interpret the statutory text, I find that these regulations exist within the range of “reasonable interpretation[s]” of the MSP Act … For example, although the sweeping language of the MSP Act does not, by itself, convince me that the statute authorizes an MAO to sue to recoup its conditional payment, that language does weigh in favor of the reasonableness of the CMS regulations. Precisely because the Private Cause of Action Provision is so open-ended with regard to who may sue, it cannot be said that the regulations’ inclusion of MAOs is contrary to the statute. Id.
    25.  This statutory section is entitled “Conditional Payment” and contains several sections relating to the repayment of conditional payments in general.
    26.  Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *5.
    27.  Id. *5,citing  Humana, 832 F.3d at 1237-38.
    28.  Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *5
    29. Id. 42 U.S.C. § 1395w22(a)(4) states as follows: (4) Organization as secondary payer Not withstanding any other provision of law, a Medicare+Choice organization may (in the case of the provision of items and services to an individual under a Medicare+Choice plan under circumstances in which payment under this subchapter is made secondary pursuant to section 1395y(b)(2) of this title) charge or authorize the provider of such services to charge, in accordance with the charges allowed under a law, plan, or policy described in such section--(A) the insurance carrier, employer, or other entity which under such law, plan, or policy is to pay for the provision of such services, or (B) such individual to the extent that the individual has been paid under such law, plan, or policy for such services.
    30. Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *5.
    31. Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *6.
    32. Id. at *6, citing In re Avandia, 685 F.3d at 365.
    33. Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *6
    34. Id. at *6 citing In re Avandia, 685 F.3d at 363 (citation omitted)
    35. Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *6
    36. Aetna Life Insurance Company v. Big Y Foods, Inc, 2022 WL 14701256 (2nd Cir. October 26, 2022), at *7.
    37. Id. at *7.  On this point, the court stated, in pertinent part, as follows: The MSP Act defines a “primary plan” as “a workmen’s compensation law or plan, an automobile or liability insurance policy or plan (including a self-insured plan) or no fault insurance[.]”  42 U.S.C. 1395y(b)(2)(A)  …  The district court found that the text of the statute clearly encompassed a self-insured tortfeasor such as Big Y. Judge Dooley explained that “[c]ourts have consistently held that a tortfeasor, insured or self-insured, can be a ‘primary plan’ for purposes of the MSP Act,” and noted that “Congress amended the MSP in 2003 to include tortfeasors and their insurance carriers in the definition of a primary plan.” Aetna, 2020 WL 4505570, at *6 (citing and quoting Collins, 73 F. Supp. 3d at 666).
    38. Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *7.
    39. Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *8, citing Aetna, 2020 WL 4505570, at *7.
    40. Aetna Life Insurance Company v. Big Y Foods, Inc., 2022 WL 14701256 (2nd Cir. October 26, 2022), at *8

Mark Popolizio, J.D.

Mark Popolizio, J.D., is vice president of MSP compliance, Casualty Solutions at Verisk. You can contact Mark at mpopolizio@verisk.com.


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