Reprinted with permission from the American Bar Association. ©2015
Pullman & Comley attorney Michael A. Kurs, member of the Health Care practice, authored the case study "May Vermont Apply Its Health Care Database Law to the Third-Party Administrator for a Self-Insured ERISA Plan?" for the American Bar Association's 2015 publication PREVIEW of United States Supreme Court Cases.
Michael's legal analysis discusses the following court case issue:
Vermont requires all public and private entities that pay for health care services provided to its residents to supply data to its "all-payer database." The requirements apply to insurers and third-party administrators, among others. The Liberty Mutual Insurance Company filed suit to block Vermont from obtaining claims data for its employee health plan claiming that the Employee Retirement Income Security Act of 1974 (ERISA) preempts any requirement that Liberty Mutual's third-party administrator provide information to Vermont's health care database. This case calls for the Court to decide whether Vermont's effort to track the health care services that are provided to its residents and the cost of those services runs afoul of ERISA's superseding authority over the regulation of employee benefit plans.
To read the entire case study, please click on the attached PDF.