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Showing posts with label medica; preauthorization. Show all posts
Showing posts with label medica; preauthorization. Show all posts

Thursday, May 16, 2013

State Law Does Not Preempt State Medical Authorization Criteria

The 5th Circuit Court of Appeals has ruled that The Texas Workers' Compensation Act does not preempt the Medicare Secondary Payer (MSP) 42 U.S.C.§ 1395y(b), as to the state statute's mandated requirement to obtain preauthorization for medical care. 

The Court ruled that.  "...Congress explicitly prohibited workers' compensation and other insurers from subordinating their payment obligations to those of Medicare." "....Congress intended the MSP to complement, not supplant, state workers' compensation rules."

Caldera v. Insurance Co, of the State of PA, ____ F.3rd ___, 2013 WL 1975660 C.A.5 (Tex), 2013. Decided May 14, 2013.