Opinion ID: 2338924
Heading Depth: 1
Heading Rank: 8

Heading: Any State law or regulation

Text: Rogers contends that regardless of the term standards, review of the arbitration provision for unconscionability should not be preempted because the phrase any State law or regulation does not include the generally applicable common laws at issue here. [4] As summarized below, this argument is unpersuasive because legislative history shows that the Act's preemption provision has been specifically amended to include generally applicable common law. Prior to 2003, Congress recognized a presumption against preemption unless a state law was in conflict with a Medicare requirement or fell within one of four express categories of preempted standards. See Balanced Budget Act of 1997, Pub.L. No. 105-33, § 1856(b)(3), 111 Stat. 251, 319; Medicare Prescription Drug Benefit, 70 Fed.Reg. 4194, 4319 (Jan. 28, 2005). In 2003, Congress reversed this negative presumption and provided that state laws are presumed to be preempted unless they fall into two specified categories[,] which are inapplicable here. Establishment of the Medicare Advantage Program, 69 Fed.Reg. 46866, 46904 (proposed Aug. 3, 2004). Because the MA program is a federal program operated by federal law, Congress explained that [s]tate laws, do not, and should not apply, with the exception of state licensing laws or state laws related to plan solvency[,] which are the two specified exceptions. Uhm, 620 F.3d at 1149 (quoting H.R.Rep. No. 108-391, at 557 (2003), 2003 U.S.C.C.A.N. 1808 at p. 1926). This language demonstrates a legislative intent to broaden the preemption provision beyond those state laws that are simply inconsistent with enumerated categories of standards. Id. at 1149-50. Accordingly, all [s]tate standards, including those established through case law, are preempted to the extent they specifically would regulate MA plans.' Id. at 1156 (quoting commentary on final rule, 70 Fed.Reg. 4588, 4665 (Jan. 28, 2005)). In light of the legislative history of the Medicare Act and the Ninth Circuit decision in Uhm, we conclude that Nevada's unconscionability doctrine is preempted to the extent that it would specifically regulate MA plans. Allowing state courts to review Medicare contracts for unconscionability risks the same result that the Ninth Circuit warned of in Uhm, namely, that materials CMS has deemed not misleadingand therefore allowed to be distributedwill later be determined likely to mislead' by a state court. 620 F.3d at 1152. Accordingly, we conclude that any inquiry into the arbitration provision's unconscionability is foreclosed by the express preemption provision in the Medicare Act.