SCOTUS to consider case alleging private plan’s ESRD coverage violates MSPA -

The Supreme Court agreed to hear the case of Marietta Memorial Hospital Employee Health Benefits Plan v. DaVita, which alleges a private healthcare plan treats members with ESRD differently than those with other conditions. In the petition, the plaintiff, DaVita, contends the Marietta Memorial Hospital’s employee plan discriminates against ESRD members, which is prohibited under the Medicare Secondary Payer Act (MSPA). DaVita noted the Marietta plan contains higher copays, coinsurance and deductibles, and treats all dialysis providers as out-of-network. This, DaVita argues, encourages plan members to switch to Medicare, where qualification is assured and costs to the patient are lower. The defendant stated a lower court ruling should be overturned, saying the decision transformed the MSPA from a coordination-of-benefits law designed to protect Medicare into an anti-discrimination statute designed to protect providers. It’s expected the justices will hear oral arguments in the case next Spring.