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The federal government won a potentially huge decision at the 11th U.S. Circuit Court of Appeals this week in a case where it seeks reimbursements to Medicare for health care expenditures for women who claimed they were injured by silicone breast implants. Judges Gerald B. Tjoflat, R. Lanier Anderson III and a visiting jurist, 7th Circuit Senior Judge Richard D. Cudahy, ruled on Monday that taxpayers could be reimbursed for Medicare payments made on behalf of the women. The decision reversed a lower court ruling that had thrown out the government’s attempt to add on to the $4.2 billion settlement hatched in 1994 between a class of plaintiffs and eight implant manufacturers. The government’s take would not come from the settlement fund, but as additional payments from the manufacturers, said Ralph I. Knowles Jr., an Atlanta plaintiffs’ lawyer who is on the class’ steering committee. Exactly how much is at stake is unclear. Because of the intimate nature of the medical procedure, the settlement kept the plaintiffs’ names confidential. The government claimed in court briefs that this makes it impossible to determine which members of the class received the Medicare benefits it wants reimbursed. Lawyers for the implant makers responded that the government has much of that information in its own files and that it failed to ask for the information in a timely or systematic way. Moreover, those lawyers argue that federal law does not entitle the government to collect insurance reimbursements from defendants. Knowles said that the class committee opposes the government’s efforts because it fears that its members could be identified if the government wins. A federal judge in the Northern District of Alabama, where the class case was based, dismissed the government’s suit in 2001 because the government could not identify the women who received Medicare money. But the 11th Circuit panel disagreed. Among other reasons noted in an 84-page opinion for the panel, Anderson wrote, “The district court applied too exacting a standard when it found the Government’s Complaint fatally deficient for failing to identify each member of the plaintiff class on whose behalf Medicare made a conditional payment.” U.S. v. Baxter International, No. 01-16782 (11th Cir. Sept. 15, 2003). Stephen B. Sanchez, a spokesman for 3M, one of the implant manufacturers, said, “We intend to seek further appellate review” of the case.

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