Prime Healthcare’s Medicare Suit Against Humana Survives

June 25, 2018, 8:21 PM

Prime Healthcare’s breach of contract suit against Humana is not preempted by the Medicare Act, according to a federal trial judge in California.

Judge Virginia Phillips of the U.S. District Court for the Central District of California June 22 dismissed Humana’s motion to dismiss the breach of contract suit. Humana argued that the Medicare Act prevented the action because the payments at issue were “explicitly governed by, and intertwined with, the Medicare Act.”

This marks one of the first times that a federal court has ruled that health-care providers can bring contract actions against Medicare managed care providers. Courts typically ...

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