Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-27T15:01:41.391Z Has data issue: false hasContentIssue false
  • English
  • Français

Kentucky Association of Health Plans, Inc. v. Miller

Published online by Cambridge University Press:  01 January 2021

Valerie Gutmann
Get access Rights & Permissions [Opens in a new window]

Extract

In Kentucky Association of Health Plans, Inc. v. Miller,, the Supreme Court unanimously held that states’ “any willing provider” laws are not preempted by the Employee Retirement Income Security Act of 1974 (ERISA). The Court ruled that states can regulate their health maintenance organizations (HMOs), and thus upheld a Kentucky law that requires insurers to reimburse services of any health care provider who is willing and able to meet established criteria. The Supreme Court has heard several cases related to ERISA in the last few years, and other such cases are working their way through the court system. Coupled with this most recent decision in Miller, the Supreme Court may significantly alter the shape of the insurance industry.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 31 , Issue 4 , Winter 2003 , pp. 729 - 731
Copyright
Copyright © American Society of Law, Medicine and Ethics 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kentucky Ass'n of Health Plans, Inc. v. Miller, 123 S.Ct. 1471, 1474 (2003).Google Scholar
See Rush, Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002) (upholding state law that required outside review of an HMO's refusal to authorize a treatment and holding that a state can require health plans to pay for review by an independent board).Google Scholar
U.S. Department of Labor, Employee Retirement Income Security Act – ERISA, at <http://www.dol.gov/dol/topic/health-plans/erisa.htm> (last visited April 22, 2003).+(last+visited+April+22,+2003).>Google Scholar
29 U.S.C.A. § 1144(a) (1974).Google Scholar
29 U.S.C.A. § 1144(b)(2)(A) (1974).CrossRefGoogle Scholar
15 U.S.C. § 1012.Google Scholar
KRS § 304.17A-270 (1994).CrossRefGoogle Scholar
Id.Google Scholar
KRS § 304.17A171(2) (1994).Google Scholar
Albeit, T., “High Court Punches Another Hole in the Federal Law Shielding HMO’s,” AMNews, at <http://www.ama-assn.org/sci-pubs/amnews/avantgo/content/g10421.htm> (last visited April 22, 2003). See also Freudenheim, M., “Industry Says Decision Wonₑt Set Back Managed Care,” New York Times, April 3, 2003, at A17.+(last+visited+April+22,+2003).+See+also+Freudenheim,+M.,+“Industry+Says+Decision+Wonₑt+Set+Back+Managed+Care,”New+York+Times,+April+3,+2003,+at+A17.>Google Scholar
Greenhouse, L., “States Can Force H.M.O.'s to Accept Any Qualified Doctor, Supreme Court Rules,” New York Times, April 3, 2003, at A17.Google Scholar
Id.Google Scholar
Freudenheim, , supra note 10.Google Scholar
Kentucky Ass’n of Health Plans, Inc. v. Nichols, 227 F.3d 352, 366 (Ky. 2000).Google Scholar
Id., citing 15 U.S.C. § 1012. The Sixth Circuit found that all three of the required factors were met.Google Scholar
See Prudential Ins. Co. of America v. National Park Medical Center, Inc., 154 F.3d 812 (1998).Google Scholar
See Miller, 123 S.Ct. 1471 at 1474.Google Scholar
Id.Google Scholar
Id. at 1475.Google Scholar
Id. at 1476.Google Scholar
Albert, , supra note 10.Google Scholar
Miller, 123 S.Ct. 1471 at 1478.Google Scholar
See id.Google Scholar
Id. at 1479.Google Scholar
Id. at 1477.Google Scholar
Id.Google Scholar
Id. at 1478.Google Scholar
Freudenheim, , supra note 10.Google Scholar
Id.Google Scholar
Id.Google Scholar
Id.Google Scholar
Id.Google Scholar
Alliance of American Insurers, Alliance Disappointed with Supreme Court Ruling on HMOs, at <http://www.allianceai.org/SearchPublicdisplay.asp?docpath=/documents/NewsReleases/html/BUNEWS-03-77.htm> (last visited April 21, 2003).+(last+visited+April+21,+2003).>Google Scholar
Id.Google Scholar
Gardner, A., “No Fast Changes Seen in High Court Ruling on HMOs,” Principal Health News, at <http://www.principalhealthnews.com/article/hscoutn/103426286> (last visited April 21, 2003).+(last+visited+April+21,+2003).>Google Scholar
Alliance of American Insurers, supra note 33.Google Scholar
Albert, , supra note 10.Google Scholar
Id.Google Scholar
Freudenheim, , supra note 10.Google Scholar