New York State Conference of Blue Cross & Blue Shield Plans, et al. v. Travelers Insurance Company, et al. (514 U.S. 645)
U.S. Supreme Court · decided April 26, 1995 · Supreme Court Database (Spaeth)
- Citation
- 514 U.S. 645 · 115 S. Ct. 1671
- Decided
- April 26, 1995
- Term
- October Term 1994
- Vote
- 9–0
- Majority author
- Justice Souter
- Issue area
- Federalism
- Disposition
- Reversed and remanded
- Outcome
- Petitioning party won
- Ideological direction
- Conservative
Opinion excerpt
Justice Souter delivered the opinion of the Court. A New York statute requires hospitals to collect surcharges from patients covered by a commercial insurer but not from patients insured by a Blue Cross/Blue Shield plan, and it subjects certain health maintenance organizations (HMO’s) to surcharges that vary with the number of Medicaid recipients each enrolls. N. Y. Pub. Health Law § 2807-c (McKinney 1993). These cases call for us to decide whether the Employee Retirement Income Security Act of 1974 (ERISA), 88 Stat. 829, as amended, 29 U. S. C. § 1001 et seq. (1988 ed. and Supp. V), pre-empts the state provisions for surcharges on bills of patients whose commercial insurance coverage is purchased by employee health-care plans governed by ERISA, and for surcharges on HMO’s insofar as their membership fees are paid by an ERISA plan. We hold that the provisions for surcharges do not “relate to” employee benefit plans within the meaning of ERISA’s preemption provision, § 514(a), 29 U. S. C. § 1144(a), and accordingly suffer no pre-emption. I A New York’s Prospective Hospital Reimbursement Methodology (NYPHRM) regulates hospital rates for all in-patient care, except for services provided to Medicare beneficiaries. N. Y. Pub. Health Law §2807-c (McKinney 1993). The scheme calls for patients to be charged not for the cost of their individual treatment, but for the average cost of…
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