Wisconsin Court of Appeals
Public Health — Medicare
A hospital can enforce a statutory lien after expiration of the time period within which the Hospital could have billed Medicare for a patient’s treatment.
“Laska fails to recognize that Gister limited Dorr to its facts. Instead, as indicated above, Laska argues that Gister has no bearing on the outcome of his case and changes nothing about our analysis. This argument lacks merit because Gister limits Dorr to the HMO context. It may be true that, after Gister, non-HMO patients remain free to argue that there is some statute or contract that makes them directly analogous to the patient in Dorr. However, Laska has not developed such an argument here. If Laska means to argue that the Provider Agreement Statute or the Department’s 2000 Memorandum interpreting that statute makes his situation directly analogous to Dorr, we reject that argument based on our analysis of federal Medicare law above.”
“Laska also fails to acknowledge or discuss Gister’s directive that courts should “ask whether the applicable statutory and regulatory framework permit the lien in light of the specific facts of the case.” See id., ¶60. As far as we can discern, we have followed this directive by conducting our analysis of federal Medicare law. Laska does not develop any argument that there is any other federal authority, or any state authority apart from Dorr, that would bar the Hospital’s lien.”
Recommended for publication in the official reports.
Dist. IV, Dane County, Albert, J., Blanchard, J.
Attorneys: For Appellant: Jansen, James R., Madison; Lanford, Rhonda L., Madison; Ryberg, Eric J., Madison; For Respondent: Sweet, Mark S., Watertown