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Supreme Court to Consider Medicare Secondary Payer Rules for Dialysis Coverage Under Employer Group Health Plans
Graydon Nov. 16, 2021 "DaVita has zeroed in on the coverage provisions for dialysis in health plans and argued that they violate a particular section of the Medicare Secondary Payer Act [which] prohibits employers and their group health plans from [1] 'taking into account' that a participant is eligible for Medicare; and [2] differentiating in coverage between participants with end stage renal disease (ESRD) and those without it. The crux of these disputes and the split between the Sixth Circuit and Ninth Circuit involves the uniformity exception found in the implementing regulations for this prohibition." [Marietta Memorial Hospital Employee Health Benefit Plan v. Davita, Inc., No. 19-4039 (6th Cir. Oct. 14, 2020; cert. pet. granted Nov. 5, 2021)] |
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