9th Circ. Frees 'Last Resort' Insurer From Medicare Payments

Law360 (October 10, 2019, 10:58 PM EDT) -- The Centers for Medicare & Medicaid Services can’t seek benefit reimbursements from an insurance guarantee association that administered workers’ compensation policies, the Ninth Circuit ruled Thursday, saying the Medicare statute was not meant to interfere with state laws protecting “last resort” funds that cover insolvent insurers.

A three-member panel said that because the California Insurance Guarantee Association isn’t a primary plan under the Medicare Secondary Payer statute, it’s shielded by the state's law protecting funds that cover member insurers when they become insolvent. A district court improperly determined that CIGA was a primary plan under the Medicare provision because it’s not a...

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