Kentucky Association of Health Plans, Inc., et al. v. Janie A. Miller, Commissioner, Kentucky Department of Insurance (538 U.S. 329)
U.S. Supreme Court · decided April 2, 2003 · Supreme Court Database (Spaeth)
- Citation
- 538 U.S. 329 · 123 S. Ct. 1471
- Decided
- April 2, 2003
- Term
- October Term 2002
- Vote
- 9–0
- Majority author
- Justice Scalia
- Issue area
- Federalism
- Disposition
- Affirmed
- Outcome
- Petitioning party lost
- Ideological direction
- Conservative
Opinion excerpt
Justice Scalia delivered the opinion of the Court. Kentucky law provides that “[a] health insurer shall not discriminate against any provider who is located within the geographic coverage area of the health benefit plan and who is willing to meet the terms and conditions for participation established by the health insurer, including the Kentucky state Medicaid program and Medicaid partnerships.” Ky. Rev. Stat. Ann. §304.17A-270 (West 2001). Moreover, any “health benefit plan that includes chiropractic benefits shall ... [p]ermit any licensed chiropractor who agrees to abide by the terms, conditions, reimbursement rates, and standards of quality of the health benefit plan to serve as a participating primary chiropractic provider to any person covered by the plan.” §304.17A-171(2). We granted certiorari to decide whether the Employee Retirement Income Security Act of 1974 (ERISA) pre-empts either, or both, of these “Any Willing Provider” (AWP) statutes. I Petitioners include several health maintenance organizations (HMOs) and a Kentucky-based association of HMOs. In order to control the quality and cost of health-care delivery, these HMOs have contracted with selected doctors, hospitals, and other health-care providers to create exclusive “provider networks.” Providers in such networks agree to render health-care services to the HMOs’ subscribers at discounted rates and to…
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