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U.S. v. BLUE CROSS & BLUE SHIELD OF MARYLAND, INC.

No. 92-1781.

989 F.2d 718 (1993)

UNITED STATES of America, Plaintiff-Appellee, v. BLUE CROSS & BLUE SHIELD OF MARYLAND, INCORPORATED, Defendant-Appellant. Blue Cross and Blue Shield Association, Amicus Curiae.

United States Court of Appeals, Fourth Circuit.

Decided March 22, 1993.

Attorney(s) appearing for the Case

Philip Vito Tamburello, Office of Corporate Counsel, Blue Cross & Blue Shield of Maryland, Inc., Owings Mills, MD, argued (Lawrence A. Richardson, Jr., Office of Corporate Counsel, Blue Cross & Blue Shield of Maryland, Inc., on the brief), for defendant-appellant.

Colette Jabes Winston, Civil Div., U.S. Dept. of Justice, Washington, DC, argued (Stuart M. Gerson, Asst. Atty. Gen., Jeffrey Axelrad, Roger D. Einerson, Civil Div., U.S. Dept. of Justice, Richard D. Bennett, U.S. Atty., Baltimore, MD, on the brief), for plaintiff-appellee.

Roger G. Wilson, Joel E. Gimpel, Blue Cross & Blue Shield Ass'n, Chicago, IL, Meryl D. Burgin, Owings Mills, MD, for amicus curiae.

Before ERVIN, Chief Judge, and WIDENER and WILKINSON, Circuit Judges.

OPINION

ERVIN, Chief Judge:

This case presents the question whether an insurance company offering gap-filling coverage to Medicare patients may construe its coverage to exclude reimbursement to VA hospitals because the hospitals do not derive benefits first from the Medicare system. We hold that it may not, and affirm the district court.

I

The facts of this case are straightforward and undisputed. Eleven veterans, who held Medicare supplemental...

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