High court to review insurance data confidentiality

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The U.S. Supreme Court will hear a case in its next term, which begins in October, on whether a self-funded insurer should have to turn over certain information to the state of Vermont — a case that could have far-reaching implications around the country, Business Insurance reported.

 

The court announced Monday that it would hear Gobeille v. Liberty Mutual Insurance Co. In the case, the state of Vermont argues it needs certain data from Liberty, such as claims and member eligibility, to help it improve the cost and effectiveness of health care. Liberty Mutual, however, argues that the federal Employer Retirement Income Security Act, known as ERISA, protects it and its third-party administrator from having to hand over the information.

 

The issue is of national consequence, the U.S. solicitor general’s office said in a brief filed in May.

 

“With the encouragement of the federal government, other states are establishing similar health care databases to help improve health outcomes for their citizens, and thus the question presented has national importance,” according to the solicitor’s brief.

 

At least 11 states have databases similar to Vermont’s, and several more are implementing such programs, according to a June brief filed on behalf of Alfred Gobeille, chair of the Vermont Green Mountain Care Board. New York, Maryland, Massachusetts, New Hampshire, Oregon and Utah have also filed a brief in the case supporting Vermont.

 

The 2nd U.S. Circuit Court of Appeals already ruled that ERISA does take precedence over state law, meaning Liberty Mutual’s third-party administrator shouldn’t have to turn over the data. ERISA regulates traditional pensions and other employer-provided benefits.