SCOTUS questions appear to support DaVita’s position in dialysis care discrimination case -

Private plans are supposed to provide coverage for dialysis for the first 30 months before the patients can transition to Medicare and there’s a statutory framework in place to ensure plans don’t lowball reimbursement. On Mar. 1, SCOTUS heard verbal arguments in the case Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., in which the dialysis provider alleges the plan adopted reimbursement rates for dialysis services that were so low, members dropped their private coverage for Medicare. DaVita argues the practice is discriminatory but Marietta contends the dialysis plan is the same for everyone and so no differentiated care is being offered. Justice Sotomayor stated the petitioner’s plan appeared “on the face of the statute not legal” because it doesn’t adhere to the “reasonable and necessary costs” standard of the framework. Justice Kagan questioned whether a private plan could find an end around the differentiation measure in the statute by finding a proxy that would cover all members.