Supreme Court Rules For States in HMO Case
April 3, 2003
In a ruling that may have a major impact on the future of health maintenance organizations (HMOs), the United States Supreme Court Wednesday determined that health care networks must accept all providers who agree to abide by their terms. The High Court decision upheld a Kentucky law, known as the any willing provider law, that prohibits HMOs from discriminating against any doctor or hospital that is willing to abide by the organization's stipulations.
The case, Kentucky Association of Health Care Plans Inc. vs. Miller, centered on whether Kentucky law was preempted by the Employee Retirement Income Security Act of 1974 (ERISA), which preempts all state laws relating to employee benefit plans but allows exemptions for state laws that regulate "insurance, banking or securities." In a written decision, the Supreme Court said that the Kentucky statute regulates insurance because it alters "the scope of permissible bargains between insurers and insureds" and therefore falls under the ERISA exemption clause.
-- Article Courtesy of InjuryBoard.com
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