In Quishenberry v. UnitedHealthcare, Inc., the Supreme Court today upholds the dismissal without trial of negligence, wrongful death, and elder abuse claims against a Medicare Advantage HMO and plan administrator for the alleged premature discharge of an 85-year-old man from a skilled nursing facility. A federal Medicare statute preempts those claims, the court concludes. It doesn’t address whether preemption would preclude claims against the facility and the man’s treating physician.
The court’s unanimous opinion by Justice Joshua Groban concludes Congress intended to broadly preclude state law actions regarding Medicare Advantage plans. Thus, the court rules that preemption applies even when the state duty asserted “is based on and duplicative of a federal standard”; when a lawsuit alleges common law claims, not solely those based on statutes or regulations; and when a plaintiff asserts violations of generally applicable law, not only law targeting Medicare Advantage plans. The plaintiff’s action cannot proceed, the court says, because liability “hinges on a determination of noncompliance with a duty rooted in federal standards established under [Medicare law].”
The court affirms the unpublished opinion of the Second District, Division Seven, Court of Appeal. It also disapproves in part the Fifth District decision in Yarick v. PacifiCare of California (2009) 179 Cal.App.4th 1158 and the Fourth District, Division Three, opinion in Cotton v. StarCare Medical Group, Inc. (2010) 183 Cal.App.4th 437. The court denied review in Cotton (with one recorded dissenting vote) and in Yarick. The court aligns itself with the Second District, Division Two, decision in Roberts v. United Healthcare Services, Inc. (2016) 2 Cal.App.5th 132. There was no petition for review in Roberts.
Related:
Review granted — see here.
Case briefs — see here.
