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MICHIGAN SPINE & BRAIN SURGEONS, v. STATE FARM

No. 13-2430.

758 F.3d 787 (2014)

MICHIGAN SPINE AND BRAIN SURGEONS, PLLC, Plaintiff-Appellant, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant-Appellee.

United States Court of Appeals, Sixth Circuit.

Decided and Filed: July 16, 2014.

Rehearing En Banc Denied August 29, 2014.

Attorney(s) appearing for the Case

ARGUED: Bryan L. Schefman , Bloomfield Hills, Michigan, for Appellant. James F. Hewson , Hewson & Van Hellemont, P.C., Oak Park, Michigan, for Appellee. ON BRIEF: Bryan L. Schefman , Bloomfield Hills, Michigan, for Appellant. James F. Hewson , Stacey L. Heinonen , Hewson & Van Hellemont, P.C., Oak Park, Michigan, for Appellee. April N. Ross , Crowell & Moring LLP, Washington, D.C. for Amicus Curiae.

Before: KEITH, CLAY, and McKEAGUE, Circuit Judges.

OPINION

McKEAGUE, Circuit Judge.

This case presents the question of whether a health care provider can bring the Medicare Secondary Payer Act's private cause of action against a non-group health plan that denies coverage for a reason besides Medicare eligibility. We hold that it can.

I.

This action arises out of an October 26, 2010 automobile accident in which State Farm's insured, Jean Warner,1 allegedly sustained...

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