Medicare Advantage Plan Loses Appeal to the Ninth Circuit
Roy Franco
April 22, 2013

This case involves the Medicare Act, one of “the most completely impenetrable texts within human experience.”  See Cooper Univ. Hosp. v. Sebelius, 636 F.3d 44, 45 (3 Cir. 2010).  We could not agree more, as a conflict now exists between Circuits on the rights of a Medicare Advantage Plan (including Part D) under the Medicare Secondary Payer Act.  The Third Circuit in In re Avandia Mktg., 685 F.3d at 356 upheld a Medicare Advantage Plans right to bring a lawsuit against primary plans for double damages.   The Ninth Circuit in Parra v. Pacificare of Arizona, 2013 U.S. App. LEXIS 7861 denied it.  Why?