On June 21, 2022, the Supreme Court of the United States (SCOTUS) ruled against DaVita Inc. in the battle over dialysis coverage for participants with End Stage Renal Disease (ESRD). In its 7-2 decision, SCOTUS ruled that plans can limit dialysis coverage under the Medicare Secondary Payer rules so long as benefits aren’t differentiated between those offered to other participants without ESRD.
This Alert summarizes the SCOTUS decision in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc. and its impact on group health plans.