Last month, the U.S. District Court for the Eastern District ofPennsylvania joined a growing number of federal courts in rejectinga Medicare Advantage (MA) plan's assertion of a federal privateright of action against casualty insurers under the MedicareSecondary 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 inseveral respects. First, the Court's ruling may be the tippingpoint 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' compensationinsurers—to pay primary to Medicare when compensating Medicarebeneficiaries for bodily injuries and related medical expenses.

Second, the decision raises the question whether CMS may requireNGHPs to report to CMS their claims payments to MA planbeneficiaries or risk a penalty of $1,000 a day under Section 111of the Medicare, Medicaid and SCHIP Extension Act of 2007 (Section111).

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