Medicare Advantage Plans Sue Puerto Rico Over Provider Pay Laws

Medicare Advantage plan providers in Puerto Rico sued the island over its attempts to enforce regulations on how plans can pay providers, arguing state laws can’t supersede federal ones under Medicare.

In their complaint filed Feb. 23 in the US District Court for the District of Puerto Rico, the Medicaid and Medicare Advantage Products Association of Puerto Rico alleged that the island’s insurance commissioner had been investigating and threatening to enforce Puerto Rico laws that would dictate the terms of their provider contracts.

These territory laws would leave managed care plans on the hook for practices that burden providers, including ...