DaVita loses employer health plan case at Supreme Court

June 21, 2022

MAYA GOLDMAN 

An employer health plan didn’t violate federal law by limiting outpatient dialysis benefits for policyholders, the Supreme Court ruled Tuesday.

The 7-2 decision holds that Marietta Memorial Hospital Employee Health Benefit Plan in Ohio followed Medicare statute because its plan doesn’t differentiate benefits for participants with end-stage renal disease.

The hospital’s health plan offers low reimbursement rates for outpatient dialysis services, that discourage providers from joining its network and effectively makes all of them out-of-network, the leading dialysis provider DaVita contended in its lawsuit.

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