Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc.
View Official PDFBelow are plain-language sections to help you understand what the Court decided in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc. and why it matters. Quotes are taken from the syllabus (the Court’s short summary at the start of the opinion).
Summary
A short, plain-English overview of Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc..
The Supreme Court ruled in favor of Marietta Memorial Hospital Employee Health Benefit Plan, finding that its uniform coverage for outpatient dialysis did not violate the Medicare Secondary Payer statute. The Court determined that the statute does not authorize disparate-impact liability and that the plan's terms apply equally to all participants. The decision reversed the Sixth Circuit's ruling, which had found a disparate impact on individuals with end-stage renal disease.
Holding
The single most important “bottom line” of what the Court decided in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc..
The Court held that Section 1395y(b)(1)(C) does not authorize disparate-impact liability, and the Marietta Plan's terms do not violate this section as they apply uniformly to all covered individuals.
Constitutional Concepts
These are the Constitution-related themes that appear in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc.. Click a concept to see other cases that involve the same idea.
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Why Preemption is relevant to Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc.
The case involves the interpretation of a federal statute, the Medicare Secondary Payer statute, and its application to a private health plan, implicating federal preemption over state or private health plan provisions.
Syllabus excerpt (verbatim)The statutory provision simply coordinates payments between group health plans and Medicare; the statute does not dictate any particular level of dialysis coverage.
Key Quotes
Short excerpts from the syllabus in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc. that support the summary and concepts above.
Section 1395y(b)(1)(C) does not authorize disparate-impact liability.
The Marietta Plan's coverage terms for outpatient dialysis do not violate § 1395y(b)(1)(C).
The statute does not dictate any particular level of dialysis coverage.
