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Wilson Sonsini Pro Bono Victory in Medicare Class Action Affirmed, Stands to Protect Appeal Rights for Vulnerable Medicare Patients Nationwide
Client Highlights
January 26, 2022

Previously, in March 2020, Wilson Sonsini, along with co-counsel Center for Medicare Advocacy (CMA) and Justice in Aging, obtained a trial victory at the district court level on behalf of a nationwide class of Medicare beneficiaries to appeal adverse classifications that affected their right to Medicare coverage for often critical care.  On January 25, 2022, following an appeal and challenge of the ruling by the defendant, a panel of the U.S. Court of Appeals for the Second Circuit issued an opinion, stating “we find no merit in these challenges. We therefore AFFIRM.”

If the affirmance stands, it will protect the rights of hundreds of thousands of Medicare patients who are older or disabled to receive Medicare coverage for care they often desperately need. Luke Liss, Wilson Sonsini Senior Counsel/Pro Bono Counsel and a member of the trial team, said, “we are thankful to the district court and the court of appeals for their time and careful attention in this matter. We are grateful for the opportunity to advocate in this case alongside our co-counsel for patients across the nation in need of critical care. Given the stakes for often very vulnerable patients who do not have time on their side, we hope that the government will accept this ruling and that a right to appeal for inpatient coverage will be implemented as soon as possible. In any event, our hearts remain with those patients who have been deprived of such opportunity, as well as the doctors and staff that have courageously advocated for them for many years. Fundamentally, this case is about fairness and care for older adults nationwide. We will continue to advocate until the right to an appeal for Medicare coverage is implemented.”

Luke also expressed Wilson Sonsini’s appreciation and admiration for co-counsel, as well as for the courage and sacrifice of the former patients and doctors that testified at trial. He further noted that one witness was particularly impactful, a physician who recounted to him on the stand an encounter with a patient who said she “just wanted to die” because her misclassification at the hospital stood to bankrupt her family. This testimony was noted in the Second Circuit’s opinion as an example of “evidence presented at trial [that] also demonstrated the emotional and psychological costs, beyond the financial costs, for a patient who is denied Medicare Part A coverage.”

The Wilson Sonsini team has been involved in this litigation against three separate administrations and overcame multiple motions to dismiss and motions for summary judgment to get to a seven-day trial in Hartford, Connecticut, in August 2019. The trial team included attorneys David J. Berger, Steven Guggenheim, Luke Liss, Dylan Savage, Lindsey Edwards, and Alexander Brehnan, and paralegals Stacy Love and Stephanie Van Horn. A number of other Wilson Sonsini attorneys and staff also assisted in the litigation over the years of Wilson Sonsini’s involvement, from 2015 through the present.

A link to CMA’s press release announcing the affirmance can be found here.

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