(1) Congress enacted the Medicare Secondary
Payer Act as a means to conserve Medicare resources.
Among other things, the Act provides that group
health plans may not "take into account" the fact that
a plan participant with end stage renal disease is eligible for Medicare benefits. Does a group health plan
that provides uniform reimbursement of all dialysis
treatments observe that prohibition?

(2) Under the Medicare Secondary Payer Act, a
group health plan also may not "differentiate" between
individuals with end stage renal disease and others "in
the benefits it provides." Does a plan that provides the
same dialysis benefits to all plan participants, and reimburses dialysis providers uniformly regardless of
whether the patient has end stage renal disease, observe that prohibition?

(3) Is the Medicare Secondary Payer Act a
coordination-of-benefits measure designed to protect
Medicare, not an antidiscrimination law designed to
protect certain providers from alleged disparate impact of uniform treatment?

Whether a group health plan that provides uniform reimbursement of all dialysis treatments observes the Medicare Secondary Payer Act's prohibition on taking into account a plan participant's Medicare eligibility