Pagarigan

Summary

This writ petition presents the question whether a Medicare health care service plan may enforce a plan arbitration provision although that provision does not comply with statutory disclosure requirements applicable to all health care service plan arbitration agreements under California law. The petitioner seeks a writ of mandate vacating the trial court’s order granting the Medicare plan’s petition to compel arbitration. Because we agree with the petitioner that neither the Federal Arbitration Act nor federal Medicare provisions preempt California’s mandatory disclosure requirements, we grant the writ petition.

Factual and Procedural Synopsis

In 1995, Johnnie Pagarigan enrolled in a Medicare HMO plan offered by Aetna U.S. Healthcare of California, Inc. Pursuant to a contract with the Health Care Financing Administration (HCFA), the federal entity that administers the Medicare program, Aetna offered replacement Medicare coverage to Medicare beneficiaries such as Pagarigan under the Senior Choice plan (later renamed the Golden Medicare plan).

Under Health and Safety Code section 1363.1 (in effect at the time of Pagarigan’s enrollment to the present), any health…