McGeorge School of Law

Elder & Health Law Clinic Receives Favorable Medicare Decision

April 16, 2015

Claxton, Lebherz, Spronsen

From left: Aaron Claxton, '17, Rick Lebherz, '15, Kimberly Van Spronsen, '16.

Students Aaron Claxton, '17, Rick Lebherz, '15, and Kimberly Van Spronsen, '16, supervised by Prof. Melissa Brown, worked on a major health law case which resulted in the estate of their deceased client receiving an order for a major healthcare provider to reimburse the family for over $100,000 in out of plan services. The issue was whether the specialized surgery and treatment for a grade IV glioblastoma brain tumor qualified for out of plan services under the Medicare HMO plan through the healthcare provider. McGeorge MSL student Patrick Browning, MD was qualified as a medical expert, whose testimony was relied on by the Judge in reaching the favorable decision.

Extensive research, a detailed brief, production of evidence, and the presentation of lay and expert witnesses at the adversary hearing, persuaded the Medicare Administrative Law Judge to reverse the denials of care. The Clinic has won each of its Medicare denial of care cases and is one of the few California sources of legal representation for Medicare patients and their families.