The Supreme Court of the United States delivered a significant decision last week regarding the future of the Patient Protection and Affordable Care Act when it upheld the healthcare subsidies, but the work continues. SCOTUS has agreed to hear a case that may determine who owns patient health data.
In Gobeille v. Liberty Mutual Insurance Company, SCOTUS will have to decide if a private, self-funded payer is required to turn over certain information to the state of Vermont.
Alfred Gobeille is chair of the Green Mountain Care Board, an independent group created by the Vermont Legislature tasked with improving health system quality and stabilizing costs in the state. Part of the board's responsibility is maintaining an all-payer statewide healthcare database, which requires all health plans operating in the state to report claims information in a certain format.
Liberty Mutual, the defendant, offers a self-insured health plan for employees. Blue Cross Blue Shield of Massachusetts, the third-party administrator for Liberty Mutual's health plan, is required to submit claims information to the aforementioned database, but had not done so. In 2011, Vermont issued a subpoena to BCBS requiring the payer to report the data, but Liberty Mutual told BCBS not to do so, saying the federal Employee Retirement Income Security Act preempted the state's all-payer database requirements. ERISA sets minimum standards for voluntary established private pension and health plans to provide protection for those enrolled in the plans.
The district court ruled the all-payer database law was not preempted by the federal law, so Liberty Mutual appealed to the second circuit. The second circuit ruled the state law was preempted by the federal law. Vermont then asked the Supreme Court to review the case.
According to Jason Lancey, partner with Foulston Siefkin, in a report for the American Bar Association, if SCOTUS agrees with the second circuit's opinion that the federal ERISA law trumps the state law, there may be little weight behind any state reporting laws. If SCOTUS goes the other way, Mr. Lancey says one could still argue that state laws don't interfere with the administration of ERISA-covered plans, especially in the realm of data breach notifications.
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