Supreme Court to decide on all-payer claims database challenge
King v. Burwell isn't the only healthcare reform case the Supreme Court will rule on next month.
The other case, Gobeille v. Liberty Mutual Insurance Company, stemmed from Vermont and involves a state-sponsored, all-payer claims database (APCD). Sixteen states have set up these databases, which are designed to collect and analyze insurer information in an effort to transform payment reform efforts, CaliforniaHealthline reported.
Liberty Mutual Insurance, which provides self-insured plans for its employees, refused to provide Vermont information, claiming that the federal Employee Retirement Income Security Act of 1974 supersedes the state's law. Liberty Mutual also alleged that data reporting already is a requirement of self-insured plans under ERISA and that Vermont's law interfered.
After a U.S. District Court rejected Liberty Mutual's position, Vermont appealed the case to the Supreme Court, which will issue its decision next month.
Some legal experts believe the Supreme Court should decline the case, noted the article. Additionally, a Liberty Mutual win may cause other self-funded employer plans to reconsider their relationship with APCDs.
Others believe the case could influence claims data systems throughout the country, Bridge Asay, solicitor general of Vermont who is representing the case, told CaliforniaHealthline.
Those in favor of APCDs turn to research that demonstrates how these databases can lower healthcare spending, further emphasizing that states should take active roles in improving healthcare price transparency. What's more, health insurers have taken initiatives to provide consumers with procedure costs which in turn leads to lower claims costs, FierceHealthPayer previously reported.
"Over the long term, if self-funded plans do not participate in APCDs, healthcare reform will suffer," Asay added.
- here's the CaliforniaHealthline piece