June 22, 2022
  • he Supreme Court ruled 7-2 that an employer-sponsored health plan can designate all dialysis providers as out-of-network. In 2018, DaVita sued Marietta Memorial Hospital alleging that its plan violated federal law by not having an in-network option for dialysis and steered patients towards Medicare, which has lower reimbursement rates. The court ruled that federal law doesn’t specifically dictate what types of benefits should be in out-of-network coverage compared to in-network. The decision may prompt businesses to amend their health coverage and lead employees with kidney failure to transition to Medicare. (Articles here and here)