United States: California’s Guaranty Fund For Insolvent Carriers Need Not Reim-burse CMS

Reversing a decision by a federal district court sitting in California, the Ninth Circuit Court of Appeals found that the California Insurance Guarantee Association (“CIGA”) need not reimburse Medicare for conditional payments Medicare had expended on behalf of various individuals whose workers’ compensation benefits CIGA was administering. The Court reasoned that CIGA was not a “workmen’s compensation law or plan” as contemplated by Medicare’s secondary payer provisions. CIGA was not a “primary plan,” but rather was a creature of insurance coverage, which was within the province of the states to regulate.

Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is co-author of Larson’s Workers’ Compensation Law (LexisNexis).

LexisNexis Online Subscribers: Citations below link to Lexis Advance.

See California Ins. Guar. Ass’n v. Azar, 2019 U.S. App. 30339 (9th Cir. Oct. 10, 2019)

See generally Larson’s Workers’ Compensation Law, § 102.04.

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law

For a more detailed discussion of the case, see