Supreme Court Agrees With 'Any Willing Provider'

April 2, 2003 (PLANSPONSOR.com) - The United States Supreme Court has unanimously ruled that states can force health maintenance organizations (HMO) to let "any willing provider" into a company's medical care network.

>Justice Antonin Scalia penned the high court’s opinion that upheld a Kentucky “any willing provider” law.   That statute said patients should have access to any health care professional willing to abide by an insurance plan’s conditions, according to a Dow Jones report.

>With its ruling, the Supreme Court rejected arguments by the Kentucky Association of Health Plans Inc that the state’s edict was preempted by ERISA provisions. “We find neither contention persuasive,” Scalia wrote in the opinion. “We do not think it follows that Kentucky has failed to specifically direct its any willing provider laws at the insurance industry.” The opinion noted the Kentucky law meets requirements for insurance regulatory exemptions from ERISA laws as set out in the McCarran-Ferguson Act, which carved out a federal exemption for insurance industry regulation.

>Conversely, the insurers argued the law did not amount to regulation of the insurance industry because it regulated the interaction of patients and medical providers rather than insurers and medical providers.  

The Supreme Court case is Kentucky Association of Health Plans vs. Miller, 00-1471.

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