SCOTUS Might Consider Legality of State Health Data Collection Laws
December 19, 2014 in News
Last week, the Supreme Court justices asked the federal government to weigh in on a case that would determine if state laws requiring self-funded insurers to submit certain health information to state databases can trump federal law, Modern Healthcare reports.
Gobeille v. Liberty Mutual Insurance Co. involves the legality of a requirement under Vermont law for self-funded insurers to submit certain information upon request to the state’s database, including:
- Claims data;
- Enrollee eligibility; and
- Other information.
According to Modern Healthcare, similar laws have been passed by 16 states.
Insurer Liberty Mutual argues that under the federal Employee Retirement Income Security Act (PL 93-406), the company and its third-party administrator are exempt from submitting the data. In a November brief filed with the Supreme Court, Liberty Mutual lawyers argued that ERISA pre-empts state law regarding data collection. They wrote, “In addition to protecting the interests of beneficiaries, Congress intended to protect plans and employers with self-funded plans (and, ultimately, employees and beneficiaries as well) from the burdens of complying with conflicting state laws by reserving the field of employee benefit plans for federal regulation.”
However, Vermont argues that state law should take precedence over federal law in this instance. The state said that it needs the data to help reduce health care costs and improve quality of care.
According to Vermont Assistant Attorney General Bridget Asay, the state uses payers’ data to:
- Analyze cost and outcome differences of similar medical procedures;
- Conduct research on care quality; and
- Track differences in care utilization by geographic area.
Asay said that the state database was not attempting to impose regulations on ERISA plans, but rather to acquire “the same basic information from ERISA plans that all public and private payers provide, to get an accurate, comprehensive picture of the health care market in that state.”
Vermont appealed to the Supreme Court after the 2nd U.S. Circuit Court of Appeals ruled that the ERISA trumps the state law and that the insurer’s third-party administrator was not required to submit the data.
A decision by the Supreme Court to not hear the case would make the 2nd circuit’s decision binding in Vermont, Connecticut and New York, according to attorney Peter Stris, whose law firm is assisting Vermont with the case. However, Stris said that such an outcome could result in more legal challenges to data collection requirements in other states.
Six states have filed an amicus brief with the Supreme Court in support of Vermont’s position:
- New Hampshire;
- New York;
- Oregon; and
The states wrote that the 2nd Circuit’s decision, if it stands, would “diminish the ability of states to improve the quality and affordability of the health care services available to their residents.”
Meanwhile, National Business Group on Health Vice President of Public Policy Steve Wojcik, said that the case addresses a broader issue of who has ownership over health data. Wojcik said, “This is probably the most prominent case and only one I know of at this point where a self-funded employer has stood up to fight for their rights to their own data” (Schencker, Modern Healthcare, 12/18).