Judge Telesca
REGAN v. METROPOLITAN LIFE INSURANCE CO. Plaintiff John Manning Regan, (Regan), a former Rochester City Court Judge, brings this proposed class action lawsuit pursuant to the Medicare as a Secondary Payer law, codified at 42 U.S.C. §1395y, against the New York State Department of Civil Service, the Metropolitan Life Insurance Company (Metlife), and the United Healthcare Services Corporation, (United). Plaintiff contends that the defendants violated his rights under the Medicare as a Secondary Payer law by failing to pay, as primary insurers, medical costs he incurred in connection with surgery to remove a carcinoma, and follow up care and treatment. Regan contends that the defendants improperly forced him to rely on Medicare as his primary medical insurance, in violation of federal law, which he contends prohibits large group health insurance plans, (such as defendants plan), from requiring employees to use Medicare benefits as their primary insurance coverage. He claims that because the defendants required him to use Medicare insurance as his primary insurance, and that because at the time of his medical treatment he was not receiving full Medicare benefits, his claims for reimbursement from the defendants were denied, and he was forced to pay over $15,000.00 in medical expenses. He seeks double damages under the Medicare as a Secondary Payer law for damages he has incurred, and seeks injunctive relief on behalf of a class of persons who have suffered damages as a result of the defendants requirement that certain employees utilize Medicare as their primary insurance. Defendants move to dismiss plaintiffs complaint on grounds that his claims are barred under the doctrine of res judicata. Defendants argue that the plaintiff had an opportunity to litigate these claims in State Court proceedings that he initiated against the same defendants, in which Regan sought reimbursement for his out-of-pocket medical expenses. Regans suit was dismissed, and the dismissal was upheld on appeal to the Supreme Court, Appellate Division, Fourth Department. The Court of Appeals subsequently denied leave to appeal, as did the Supreme Court of the United States. Defendants argue that because the plaintiff could have brought the instant claims in his state court proceeding, he is barred from asserting those claims in this action.
