(a) 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) for Part D plans offered by Part D plan sponsors.
(b) State premium taxes prohibited—(1) Basic rule. No premium tax, fee, or other similar assessment may be imposed by any State, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, and American Samoa, the Mariana Islands or any of their political subdivisions or other governmental authorities for any payment CMS makes on behalf of Part D plan or enrollees under this part (including the direct subsidy, reinsurance payments, and risk corridor payments); or for any payment made to Part D plans by a beneficiary or by a third party on behalf of a beneficiary.
(2) Construction. Nothing in this section may be construed to exempt any Part D plan sponsor from taxes, fees, or other monetary assessments related to the net income or profit that accrues to, or is realized by, the organization from business conducted under this part, if that tax, fee, or payment is applicable to a broad range of business activity.
Notes of Decisions
Do Sung Uhm v. Humana, Inc. (2010)
ca9 · cites it 2×
“§ 1395w-26(b)(3); see also 42 C.F.R. § 423.440 (a) (2005) (adopting the same language in the Part D implementing regulation: “The standards established under this part supersede any State law or regulation (other than State licensing laws or State laws relating to plan solvency)…”
Uhm v. Humana Inc. (2008)
ca9
“See also 42 C.F.R. § 423.440 (a) (adopting same language in Part D implementing regulations: “The standards established under this part supercede any State law or regulations (other than State licencing laws or State laws relating to plan solvency) for Part D plans offered by…”
Dial v. Healthspring of Alabama, Inc. (2007)
alsd
“” 42 C.F.R. § 423.440 (a). In Uhm , plaintiffs, brought claims for breach of contract, violation of state consumer protection statutes, unjust enrichment, fraud, and fraud in the inducement because, after numerous requests, forms and instructions for mail ordering of drugs (as…”
PA Life & Health Ins. Guaranty Assoc. v. PA Ins. Dept. (2019)
pacommwct · cites it 4×
“] 42 C.F.R. §423.440 (emphasis added). 4 PLHIGA Act PLHIGA is a nonprofit, unincorporated association created by the legislature to provide protection to Pennsylvania policyholders whose coverage was provided by an insolvent life and health insurer.”
Uhm v. Humana Inc (2008)
ca9 · cites it 2×
“See also 42 C.F.R. § 423.440 (a) (adopting same language in Part D implementing regulations: “The standards established under this part supercede any State law or regulations (other than State licencing laws or State laws relating to plan solvency) for Part D plans offered by…”
Prime Healthcare La Palma v. Kaiser Foundation Health Plan CA2/7 (2021)
calctapp
“Specifically, Prime relies on the following statements by CMS in promulgating the regulation containing an express preemption clause applicable to Medicare Part D plans ( 42 C.F.R. § 423.440 (a)), which is substantially the same as the Medicare Part C preemption clause: “In…”
The State of Alaska v. Express Scripts, Inc. (2024)
akd
“[b]ases clinical decisions on the strength of scientific evidence and standards of practice,” “[c]onsiders whether the inclusion of a particular Part D drug in a formulary or formulary tier has any therapeutic advantages in terms of safety and efficacy,” and “[r]eviews policies…”
Heino v. U.S. Center for Medicare (2023)
ord
“§ 1395w-26(b)(3); see also 42 C.F.R. § 423.440 (a) (incorporating the same language into the Part D implementing regulation, which provide: “The standards established under this part supersede any State law or regulation (other than State licensing laws or State laws relating to…”
Williams v. Aetna Better Health of Ohio (2024)
ohsd
“§ 1395w–26(b)(3); see also 42 C.F.R. § 423.440 (a) (adopting the same language for Part D: “The standards established under this part supersede any State law or regulation (other than State licensing laws or State laws relating to plan solvency) for Part D plans offered by Part…”
— 42 C.F.R. § 423.440(a) — 1 case
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