By Jennifer Carsen, JD, Legal Editor
On March 1, 2016, the U.S. Supreme Court ruled against the state of Vermont in an Employee Retirement Income Security Act (ERISA) case that could have broad implications for states’ ability to regulate healthcare practices and reforms within their borders.
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Vermont law requires certain entities, including health insurers, to report payments relating to healthcare claims and other information relating to healthcare services to a state agency for compilation in an all-inclusive healthcare database.
Liberty Mutual Insurance Company offers a health plan covered under ERISA. Liberty Mutual’s third-party administrator, Blue Cross Blue Shield of Massachusetts (BCBS), took issue with the Vermont database when it was asked to hand over files relating to eligibility, medical claims, and pharmacy claims for the Liberty Mutual plan’s Vermont members.
Liberty Mutual intervened on BCBS’s behalf and filed a lawsuit against Vermont, claiming that ERISA pre-empts Vermont’s reporting scheme as it relates to the plan.