Massachusetts Association Of Health Maintenance Organizations v. Linda Ruthardt, Commissioner Of Insurance, 1999 U.S. App. LEXIS 25348 (1^st Cir. Oct. 8, 1999)- Seeking to aid Medicare beneficiaries, the Massachusetts legislature passed a law compelling all HMOs to offer at least one plan that included unlimited outpatient prescription drug coverage. An association of health care providers sought a declaration that the state law was preempted by federal law, specifically the Medicare + Choice Program contained in the Balanced Budget Act of 1997. The district court found preemption, and this court affirmed. This court looked to the express preemption language contained in the federal law, and found that none of appellant’s various arguments of statutory interpretation were convincing.