SCOTUS sides with OH-based medical plan in dispute with DaVita over dialysis reimbursements -

In a 7-2 vote, the Supreme Court ruled in favor of the Marietta Memorial Hospital Employee Benefit Plan in a case that hinged on a Medicare rule prohibiting different levels of coverage for patients with ESRD and those without. DaVita accused the plan of discrimination, saying it was forcing members with ESRD off their private plan and onto Medicare by lowering reimbursements. SCOTUS rejected that argument, stating there’s nothing in the Medicare Secondary Payer statute delineating how much dialysis coverage a private plan should provide. Fresenius said that to limit coverage isn’t “an appropriate or ethical behavior” and that most of its payer partners are more interested in patient well-being. Meanwhile, the advocacy organization Dialysis Patient Citizens expressed its disappointment with the SCOTUS ruling, saying that forcing ESRD patients onto Medicare before the 30-month expiration of privately insured benefits “represents immediate and profound risks for kidney patients.”