Rush Prudential HMO, Inc. v. Moran

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Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002), was a decision by the Supreme Court of the United States in which the court held that the federal Employee Retirement Income Security Act (ERISA) did not preempt an Illinois medical-review statute.[_clarification needed
_][1] [2] [3]

ERISA envisions a national standard for welfare and pension plans so state laws which "relate to" ERISA plans are preempted under Section 514 of ERISA. However, ERISA contains a "savings" clause which saves state laws which regulate insurance under Section 514(b). The statute at issue in Moran regulated insurance, which is one of the functions HMOs perform. Although HMOs provide healthcare as well as insurance, the statute does not require choosing a single or primary function of an HMO . Congress has long recognized that HMOs are risk-bearing organizations subject to state regulation. Finally, allowing States to regulate the insurance aspects of HMOs will not interfere with the desire of Congress for uniform national standards under ERISA .

This case was partially overruled in _Kentucky Ass'n of Health Plans, Inc. v. Miller _, 538 U.S. 329 (2003).

References

(https://en.wikipedia.org/w/index.php?title=Rush_Prudential_HMO,_Inc._v._Moran&action=edit&section=1 "Edit section: References")

1. ↑ Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002).
2. ↑ Reinhart, Stephanie (January 1, 2004). "Rush Prudential HMO, Inc. v. Moran: 21 or Bust! Does ERISA Preemption Give HMOs the Power to Gamble with Our Health?" . Akron Tax Journal. 19 (1). ISSN  0002-371X .
3. ↑ Berman-Sandler, Leatrice (January 1, 2004). "Independent Medical Review: Expanding Legal Remedies to Achieve Managed Care Accountability" . Annals of Health Law and Life Sciences. 13 (1): 233. ISSN  1075-2994 .

External links

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• Text of Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002) is available from: CourtListener Google Scholar Internet Archive (docket files) Justia Library of Congress Oyez (oral argument audio)

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