42 C.F.R. § 422.402
Federal preemption of State law
The standards established under this part supersede any State law or regulation (other than State licensing laws or State laws relating to plan solvency) with respect to the MA plans that are offered by MA organizations.
Notes of Decisions
Cited in 27
cases (4 in the last 5 years), 1999–2025 · leading case: McCall v. PacifiCare of California, Inc.
McCall v. PacifiCare of California, Inc. (2001)
“( 42 C.F.R. § 422.402 (1999).) All other types of state laws not inconsistent with Medicare standards are permitted.”
Pagarigan v. Superior Court (2002)
“” ( 42 C.F.R. § 422.402 (a), (b) (1998), italics added.”
Do Sung Uhm v. Humana, Inc. (2010)
“42 C.F.R. § 422.402 (a) (1998). In CMS’s request for comments on this interim final rule, the Secretary stated that neither the statute nor the regulation “preempt[ed] State remedies for issues other than coverage under the Medicare contract (i.”
Premier Inpatient Partners LLC v. Aetna Health and Life Insurance Company (2019)
“§ 1395w-22(g)(5) ; 42 C.F.R. § 422.402 . In essence, Defendant argues that the preemption exception to the well-pleaded complaint rule applies to Plaintiff's claims because "a federal statute wholly displaces the state-law cause[s] of action through complete pre-emption.”
Fairfield County Medical Ass'n v. United Healthcare (2013)
“42 C.F.R. § 422.402 (“The standards established under this part supersede any State law or regulation (other than State licensing laws or State laws relating to plan solvency) with respect to the MA plans that are offered by MA organizations.”
Potts v. Rawlings Co. (2012)
“4 See also 42 C.F.R. § 422.402 . Courts have held that “[f]or purposes of the preemption provision, a standard is a statutory provision or a regulation promulgated under the [Medicare Act] and published in the Code of Federal Regulations.”
Palmer v. St. Joseph Healthcare P.S.O., Inc. (2003)
“42 C.F.R. § 422.402 (a), (b) (1998). {20} In BIPA, Congress amended Subsection (B) (Standards specifically superseded) of § 1395w-26(b)(3) and broadened its preemption coverage.”
Massachusetts Ass'n of Health Maintenance Organizations v. Ruthardt (1999)
“34,968, 35,099 (June 26, 1998) (codified at 42 C.F.R. § 422.402 (1998)). This rule remains in effect.”
Humana Medical Plan, Inc. v. Reale (2015)
“76 may be applicable to determine Humana’s right to reimbursement, it is preempted by the broad, express preemption clause in Part C of the Medicare Act: (3) Relation to State laws The standards established under this part shall supersede any State law or regulation (other than…”
Medical Card System, Inc. v. Equipo Pro Convalecencia (2008)
“§ 1395w-26(b)(3); 42 C.F.R. § 422.402 . Thus, federal law controls to the extent that federal standards exist; state common law prevails where neither Congress nor CMS has established standards.”
Christus Health Gulf Coast v. Aetna, Inc. (2005)
“See 42 C.F.R. § 422.402 (b)(3) (2003) (stating that the Medicare Act preempts all state law coverage determinations); Medicare + Choice Program, 65 Fed.”
Estate of Ethridge v. Recovery Management Sytems, Inc. (2014)
“In 2004, following the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act, the Secretary submitted for public comment a proposed revision to 42 C.F.R. § 422.402 — CMS’s regulation governing federal preemption of state law generally — that would…”
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