In 2022, the US Supreme Court held in a 7-2 opinion that group health plans can utilize cost-control designs under the Medicare Secondary Payment Act (MSPA).
This supreme court decision, specifically the statutory and regulatory scheme the Supreme Court was interacting with in this case will be discussed.
Shortly after this ruling, legislation was introduced in both the Senate and House (S.4750 and H.R.8594) in response to the Supreme Court decision. These bills would require plan sponsors to impose limitations and restrictions placed on dialysis coverage to similarly impose these limitations and restrictions on all other chronic diseases covered under the plan. But far from protecting patients, S.4750/H.R. 8594 would eliminate the ability of employer groups to increase price transparency and reduce healthcare costs for high quality dialysis treatments.
Please join Professor Chris Walker -who represented SIIA as amicus curiae before the US Supreme Court in Marietta Memorial Hospital Employee Health Benefit Plan v DaVita, in a spirited and informative discussion on, the Supreme Court Decision, S. 4750/ H.R. 8594 and how these can affect the marketplace moving forward.