United States Ninth Circuit

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Parra v. Pacificare of Arizona, Inc., 11-16069

The district court correctly ruled that a private Medicare Advantage Organization (MAO) plan, such as defendant, cannot sue a plan participant's survivors for reimbursement for advanced medical expenses out of the proceeds of an automobile insurance policy, where: 1) the district court had subject matter jurisdiction to determine whether the Medicare Act created a cause of action in favor of the MAO plan; and 2) even though the MAO Statute, Medicare Part C, allows an MAO to charge a primary plan for conditional payments made on behalf of a plan participant, it does not grant an MAO a private right of action to recover those payments.

Appellate Information

  • Decided 04/19/2013
  • Published 04/19/2013

Judges

  • HURWITZ

Court

  • United States Ninth Circuit

Counsel