Appeals Court ruling supports MA organization request for refund of B&O taxes paid on premiums

On April 1, 2019, the Washington Court of Appeals Division 1 ruled unanimously in a published opinion that premiums received by Medicare Advantage (“MA”) organizations from or on behalf of their members are not subject to Washington’s business and occupation (“B&O”) tax. Grp. Health Coop. v. Dep’t of Rev., No. 79091-9-1 (Wn. Ct. App. Apr. 1, 2019).

Washington’s B&O tax is imposed broadly on gross receipts but incorporates numerous exemptions, including an exemption for “premiums or prepayments that are taxable under RCW 48.14.0201 [Washington’s premium tax].” RCW 82.04.322. MA premiums are not subject to Washington’s 2% tax, which includes an exemption for Medicare premiums. RCW 48.14.0201. The Washington State Department of Revenue (“DOR”) has imposed B&O tax on MA premiums, reasoning that their exemption from the premium tax renders them ineligible for the exemption under the B&O tax.

Group Health Cooperative and Group Health Options, Inc. (collectively, “Group Health”) applied for a refund of the B&O tax imposed on its MA premium payments, asserting that MA premiums were exempt from the state’s B&O tax, or alternatively that the B&O tax on MA premium payments was preempted by federal law. The complaint was summarily dismissed in trial court. The court of appeals agreed with DOR’s interpretation of state law holding that MA premiums are not exempt from B&O tax, but reversed the lower court on the issue of federal preemption.

A federal law enacted with the Balanced Budget Act of 1997 provides that “[n]o State may impose a premium tax or similar tax with respect to [MA premiums].” 42 U.S.C. § 1395w-24(g). The appeals court agreed with Group Health that this language preempts state law imposing B&O tax because the B&O tax shared key characteristics with, and thus is similar to, a premium tax. First, this is a case of DOR imposing the B&O tax on premiums, just like an explicit premium tax. Second, both the B&O tax and the premium tax are assessed on a gross basis. In holding that federal law preempts DOR from implementing a B&O tax on MA premiums the court stated that Group Health was entitled to a refund of the B&O taxes previously paid.

It is unclear at this time whether the DOR will try to appeal to the Washington Supreme Court, and whether that court will accept the case for review. Regardless, as a result of this decision, any MA organization that has paid B&O tax on their MA premiums in Washington should immediately seek assistance in requesting a refund from the DOR. MA organizations should not wait to see if the matter is further appealed and should act now to preserve any potential refund claim.

For help requesting a refund, or if you have additional questions about this case and its implications, please contact Chauncey MacLean at chauncey.maclean@stoel.com or (206) 386-7551, or Kara Morse at kara.morse@stoel.com or (206) 386-7657.

Photo of Kara Morse Kara Morse

Kara Morse focuses her practice on providing regulatory and corporate transactional assistance to medical groups, managed care companies and other health care entities. Kara draws upon her public policy experience as well as her research and legal aid experience to advise clients in…

Kara Morse focuses her practice on providing regulatory and corporate transactional assistance to medical groups, managed care companies and other health care entities. Kara draws upon her public policy experience as well as her research and legal aid experience to advise clients in health care-related matters ranging from corporate mergers and acquisitions, joint ventures and reorganization to fraud and abuse, corporate practice of medicine and provider contracting. With a focus on health care delivery transformation and managed care, Kara helps her clients navigate through the full range of issues facing the health care industry as they work to achieve the triple aim of better patient care, better health outcomes and lower costs.

Kara is an active member of the community, participating in organizations that champion diversity, inclusion and equal access to health care. Prior to joining Stoel Rives she was a consultant for the National Nursing Centers Consortium where she researched state health information sharing laws. Kara was also a summer associate at Ballard Spahr LLP and a legal intern for Temple Legal Aid and the Philadelphia Law Department. Before law school she was an associate with The Raben Group, a political consulting firm, where she focused on nonprofit advocacy.