News Feature | January 7, 2015

Supreme Court To Rule On Healthcare Data

Katie Wike

By Katie Wike, contributing writer

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The Supreme Court will soon make a decision regarding the collection of healthcare data that could affect 16 states.

Should self-funded insurers have to hand over certain information to state databases upon request? That’s the question being asked in Gobeille v. Liberty Mutual Insurance Co., a case being heard by the Supreme Court soon. According to Modern Healthcare, the court will decide if self-funded insurers will be subject to sharing their health data or if they are exempt from the federal rule.

The state of Vermont says it need healthcare data (including that on claims, member eligibility, and other issues) in order to improve the cost and effectiveness of healthcare. The insurance company, however, says the federal Employee Retirement Income Security Act, or ERISA, exempts it and its third-party administrator from having to submit the information to state databases.

Bridget Asay, a Vermont assistant attorney general said in an email, “The states merely seek the same basic information from ERISA plans that all public and private payers provide, to get an accurate, comprehensive picture of the healthcare market in that state.”

Health IT Security says this decision could affect the data collection programs in 16 states. New York, Maryland, Massachusetts, New Hampshire, Oregon, and Utah also filed a brief in the case, in favor of Vermont.

“At stake is whether States can audit the cost and effectiveness of the healthcare provided within their borders and to their residents by requiring all in-state health-care payers – including self-funded insurance plans – to report medical claims data that such payers collect in the ordinary course of business,” stated the supporting states’ brief.