WASHINGTON-The Supreme Court has ducked a showdown on the power of ERISA to supersede any-willing-provider laws.
Without comment, the Court refused to hear a Louisiana appeal of a decision by the Fifth Circuit Court. Its ruling had overturned a state law that opened PPOs to all qualified comers.
The lower court found that the state law conflicted with federal ERISA statutes, which protect self-insured employers from conflicting state statutes.
The state had been sued by Cigna HealthCare. But Cigna, despite its victory, was unhappy that the High Court refused to hear the case.
“Because of the important public-policy implications of this issue, and the conflict in various court decisions nationwide, a U.S. Supreme Court ruling on this matter would have offered needed clarification and consistency in the application of ERISA,” said Cigna.
Others felt that the issues were clear-cut in Louisiana, and that the court was wise in awaiting a thornier legal point before tackling ERISA’s impact on any-willing-provider laws.
Such a case involving HMOs has been creeping through the courts in Arkansas. It’s one of four states-besides Idaho, Kentucky, and Wyoming-with legislation mandating that HMOs must live under any-willing-provider laws for physicians.
The HMO industry rails against having to accept any “Tom, Doc, and Harry,” claiming that selective contracting with physicians is at the heart of managed care’s quality and affordability.
The AMA hasn’t backed any-willing-provider laws, but it’s opposed to federal efforts to preempt laws in states that have them. It had no comment on the Louisiana decision. -Mark Bloom
WASHINGTON-The Supreme Court has ducked a showdown on the power of ERISA to supersede any-willing-provider laws.
