Last month, the U.S. District Court for the Eastern District of Pennsylvania joined a growing number of federal courts in rejecting a Medicare Advantage (MA) plan’s assertion of a federal private right of action against casualty insurers under the Medicare Secondary Payer (MSP) laws. [Humana v. GlaxoSmithKline, No. 10-6733, 2011 WL 2413488 (E.D. Pa. June 13, 2011.)] 

The opinion in this case is significant for casualty insurers in several respects. First, the Court’s ruling may be the tipping point that compels the Centers for Medicare & Medicaid Services (CMS) to seek Congressional amendment of a collection of complex, disjointed MSP provisions that require “non-group health plans” (NGHPs)—including liability, no-fault, and workers’ compensation insurers—to pay primary to Medicare when compensating Medicare beneficiaries for bodily injuries and related medical expenses.

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