McCall v. Pacificare of California, Inc

McCall v. Pacificare of California, Inc.,

No. S082236 (Cal. May 3, 2001)

An enrollee sued his Medicare HMO after one of its physicians repeatedly refused
to provide him with referrals and services incidental to his lung disease. The
HMO argued that all of the enrollee’s claims were subject to the Medicare Act’s
requirement that complainants exhaust their administrative remedies prior to
filing suit in court. The California Supreme Court declared that state tort
claims brought against a Medicare provider are not preempted by the Medicare
Act and are not subject to the administrative exhaustion requirement.