govinfo:USCOURTS-ncmd-1_25-cv-00712-1

IN THE UNITED STATES DISTRICT COURT 
FOR THE MIDDLE DISTRICT OF NORTH CAROLINA 
 
BRANDON RULUND AKINS, 
 
 Plaintiff, 
 
v. 
 
TASHI LAWTON RATLIFF, ET AL.,
 
 
 Defendants. 
 
 
1:25-CV-712-DAB-LPA 
 
 
 
 
 
 
ORDER 
 
The Magistrate Judge granted Plaintiff’s application to proceed in forma 
pauperis for the limited purpose of recommending dismissal under 28 U.S.C. 
§ 1915(e)(2)(B). 4/28/26 Opinion, Order, and Recommendation , D.E. 32, at 1. 
Although Plaintiff purported to invoke Federal Question Jurisdiction based on the 
Medicare Secondary Payer Act , the Magistrate Judge concluded that he failed to 
state an MSPA claim because he did not allege Medicare made conditional payments 
or that Defendant’s responsibility to pay was established through an enforceable 
obligation such as a judgment or settlement. Id. at 11–14. 
 
The Magistrate Judge further recommended dismissal of Plaintiff’s state-law 
claims, including breach of good faith and fair dealing and violations of North 
Carolina’s Unfair Claims Settlement Practices Act and Unfair and Deceptive Trade 
Practices Act, because the sole federal claim was subject to dismissal. Id. at 16–17. 
 
Plaintiff objected. 5/18/26 Objection, D.E. 34. Defendant responded. 5/29/26 
Response, D.E. 35 . Following de novo review under Fed. R. Civ. P. 72(b)(3), and 
liberally construing Plaintiff’s pro se objections, the Court adopts the 
Recommendation. 
 
No party has objected to the Magistrate Judge’s summary of the background 
of this case, so the Court adopts the facts set forth in the Recommendation. See 
D.E. 10 at 3–7; Thomas v. Arn, 474 U.S. 140, 152 (1985). 
 

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I. Plaintiff’s First Objection 
 
Plaintiff argues that the Magistrate Judge improperly treated his MSPA claim 
as a routine settlement dispute rather than one arising from Medicare conditional 
payments and reimbursement obligations under 42 U.S.C. § 1395y(b) and contends 
that Defendant’s claim -handling conduct demonstrates “responsibility” to pay 
through other means. D.E. 34, at 1–2. 
 
These arguments are unavailing. The Complaint does not allege that Medicare 
actually made conditional payments on Plaintiff’s behalf or that Defendant’s 
responsibility to pay was established through an enforceable obligation, such as a 
judgment or settlement, both prerequisites to an MSPA private cause of action. Sims 
v. PMA Ins. Co. , No. 1:20cv249, 2021 WL 369675, at *7 n.8 (M.D.N.C. Feb. 3, 
2021). Instead, it alleges only that Plaintiff receives Medicare and incurred medical 
expenses. D.E. 2, at 8; 11. Plaintiff’s assertion in his Objection that Medicare issued 
conditional payments is not supported by the Complaint and does not substitute for 
allegations that Medicare actually paid covered claims on Plaintiff’s behalf. D.E. 34, 
at 2; Leggette v. B.V . Hedrick Gravel & Sand Co., No. 3:04cv530, 2006 WL 6809606, 
at *11 (W.D.N.C. May 24, 2006). Absent allegations of actual Medicare payments, 
Plaintiff cannot establish the basis for MSPA double damages. 42 U.S.C. 
§ 1395y(b)(3)(A). Dismissal is therefore warranted. 
 
II. Plaintiff’s Second Objection 
 
Plaintiff argues that Defendant’s claim-handling conduct, including settlement 
communications, requests for medical documentation, and alleged references to 
Medicare/TRICARE reimbursement requirements, demonstrates “responsibility” to 
pay under the MSPA through “other means” under 42 U.S.C. § 1395y(b)(2)(B)(ii). 
D.E. 34, at 2–3. 
 
However, MSPA “responsibility” must be shown through an enforceable 
obligation, such as a judgment or settlement, and cannot be established through 
routine claim-handling, negotiations, or unaccepted settlement offers as attempted 
to do so here. 42 U.S.C. § 1395y(b)(2)(B)(ii). Accordingly, dismissal is appropriate. 
 
III. Plaintiff’s Third Objection 
 
Plaintiff suggests that dismissal with prejudice is premature and seeks leave 
to amend to clarify the MSPA framework and add factual allegations, recognizing 
that the “current pleading may not yet fully articulate the federal statutory framework 

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and Defendant’s alleged violations.” D.E. 34, at 4 . He contends that amendment 
would cure any deficiencies and support supplemental jurisdiction over his state-law 
claims under 28 U.S.C. § 1367. Id. 
 
These arguments are unavailing because amendment would be futile, as 
Plaintiff has not identified additional facts that would cure the fundamental 
deficiencies in his MSPA claim. Namely, the absence of allegations showing actual 
Medicare payments or a demonstrated enforceable obligation establishing 
Defendant’s responsibility to pay. 
 
Since the MSPA claim is subject to dismissal, the Court decline s to exercise 
supplemental jurisdiction over the state-law claims for the reasons explained by the 
Magistrate Judge. 
 
CONCLUSION 
 
The Court has reviewed the Recommendation and Plaintiff’s objections and 
finds that the recommended disposition of this case is supported by the record and 
law. The Court accepts the Magistrate Judge’s Recommendation that the Plaintiff’s 
case be dismissed and dismisses the MSPA claim with prejudice and the remaining 
state law claims without prejudice. 
 
It is therefore ORDERED that the Plaintiff’s Objections, D.E. 34, are 
overruled, and the Recommendation of the Magistrate Judge, D.E. 32, is accepted. 
Defendant’s Motion to Dismiss, D.E. 7, is TERMINATED AS MOOT. 
 
This the 5th day of June, 2026. 
 
 /s/ David A. Bragdon 
United States District Judge 
 

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