Case: Health & Welfare Benefits/Reduced Payments (9th Cir.)

Congress did not intend payment by Medicare to be a prerequisite to bringing a private cause of action under the Medicare as Secondary Payer law, the U.S. Court of Appeals for the Ninth Circuit held. Dialysis provider DaVita, Inc. sued Virginia Mason Memorial Hospital and its Yakima Valley Memorial Hospital’s Employee Health Care Plan, saying the plan failed to comply with the statute when making a reduced payment on account of the patient’s Medicare eligibility. The district court erred when it dismissed the complaint on the basis of its holding that the MSP’s private cause of action is available only ...