United Seniors Association, Inc. v. Philip Morris USA, et al.
United Seniors Association brought action against five tobacco companies, seeking reimbursement for the costs incurred by the federal Medicare program since 1999 from the medical treatment of persons suffering from smoking-related illnesses. The lower court had dismissed the case, holding that United Seniors Association could not file for compensation before the alleged damage was determined. The court affirmed the dismissal, but on a different ground. The Court held that United Seniors Association did not have standing under Medicare Secondary Payer statute because it had failed to allege that it represented Medicare beneficiaries "who received unreimbursed Medicare payments for treatment of smoking-related injuries" and because MSP does not provide for a qui tam (whistle blower) action and therefore, the companies could not be penalized.
United Seniors Association, Inc. v. Philip Morris USA, et al., 500 F.3d 19 (1st Cir. 2007).
Governments or insurance agencies may seek reimbursement from the tobacco companies for health care costs related to tobacco. The most famous example is the case brought by individual states in the U.S.A. that resulted in the Master Settlement Agreement.
The court might consider procedural matters without touching the merits of the case. These might include: improper joinder, when third parties, such as Health NGOs or government officials, seek to become parties to the suit; lack of standing, where a plaintiff fails to meet the minimum requirements to bring suit; lack of personal jurisdiction, where the court does not have jurisdiction to rule over the defendant; or lack of subject matter jurisdiction, where the court does not have jurisdiction over the issue at suit.
Type of Tobacco Product
None
Limitations regarding the use of quotes The quotes provided here reflect statements from a specific decision. Accordingly, the International Legal Consortium (ILC) cannot guarantee that an appellate court has not reversed a lower court decision which may influence the applicability or influence of a given quote. All quotes have been selected based on the subjective evaluations undertaken by the ILC meaning that quotes provided here may not accurately or comprehensively represent a given court’s opinion or conclusion, as such quotes may have originally appeared alongside other negative opinions or accompanying facts. Further, some quotes are derived from unofficial English translations, which may alter their original meaning. We emphasize the need to review the original decision and related decisions before authoritatively relying on quotes. Using quotes provided here should not be construed as legal advice and is not intended to be a substitute for legal counsel on any subject matter in any jurisdiction. Please see the full limitations at https://www.tobaccocontrollaws.org/about.
"By contrast to FCA § 3730(b), MSP § 1395y(b)(3)(A) reads, in its entirety: "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)." No mention is made of any jointly-held cause of action by the government and the private plaintiff, or of the private plaintiff's right to sue solely in behalf of the government. Indeed, the MSP contemplates that the government has its own independent causes of action, either direct or in subrogation. See 42 U.S.C. § 1395y(b)(2)(B)(iii), (iv); supra note 2. Tellingly, Congress created the causes of action in FCA § 3730(b) and MSP § 1395y(b)(3)(A) during the same month in 1986,6 and if it had meant unambiguously to create a qui tam action in the latter section, it readily could have used—but did not—the same explicit assignment language it employed in § 3730(b) (viz., "a person may bring a civil action . . . for the person and for the United States") in § 1395y(b)(3)(A). See Mullane v. Chambers, 333 F.3d 322, 331 (1st Cir.2003) (consulting other statutes to ascertain that Congress knew how to include an express exclusion "and could have done so clearly and explicitly"); accord Wood v. Spencer, 487 F.3d 1, 6 (1st Cir.2007) ("Congress acts intentionally and purposely when it includes particular language in one section of a statute but omits it in another.") (citation omitted)."
Limitations regarding the use of quotes The quotes provided here reflect statements from a specific decision. Accordingly, the International Legal Consortium (ILC) cannot guarantee that an appellate court has not reversed a lower court decision which may influence the applicability or influence of a given quote. All quotes have been selected based on the subjective evaluations undertaken by the ILC meaning that quotes provided here may not accurately or comprehensively represent a given court’s opinion or conclusion, as such quotes may have originally appeared alongside other negative opinions or accompanying facts. Further, some quotes are derived from unofficial English translations, which may alter their original meaning. We emphasize the need to review the original decision and related decisions before authoritatively relying on quotes. Using quotes provided here should not be construed as legal advice and is not intended to be a substitute for legal counsel on any subject matter in any jurisdiction. Please see the full limitations at https://www.tobaccocontrollaws.org/about.
United Seniors Association brought action against five tobacco companies, seeking reimbursement for the costs incurred by the federal Medicare program since 1999 from the medical treatment of persons suffering from smoking-related illnesses. The lower court had dismissed the case, holding that United Seniors Association could not file for compensation before the alleged damage was determined. The court affirmed the dismissal, but on a different ground. The Court held that United Seniors Association did not have standing under Medicare Secondary Payer statute because it had failed to allege that it represented Medicare beneficiaries "who received unreimbursed Medicare payments for treatment of smoking-related injuries" and because MSP does not provide for a qui tam (whistle blower) action and therefore, the companies could not be penalized.