Supreme Court hears all-payer claims database case

In a Supreme Court hearing Wednesday, a health insurer made the case that states do not have the authority to require self-insured plans to supply cost and quality information for their databases--an argument many of the justices seemed to agree with.

The case, Gobeille v. Liberty Mutual, concerns the legality of Vermont's all-payer claims database, which requires insurance companies, including self-insured plans, to report to a statewide database. Opponents of such databases, including Liberty Mutual Insurance Company, argue that the federal Employee Retirement Income Security Act supersedes any state-based data reporting requirements for self-insured plans.

At stake is states' ability to maintain such databases--as 18 so far have--or start them in order to encourage price transparency, the Associated Press notes. Indeed, New Mexico launched its own in August, FierceHealthPayer has reported. The case also has major implications for health information exchanges, according to a recent perspective article in the New England Journal of Medicine.

But justices Stephen Breyer and Elena Kagan were skeptical about the prospect of allowing each state to determine its own regulations, with Kagan saying it "just all adds up to a lot of hassle, which all adds up to a lot of money," according to the AP.

Still, Breyer agreed with Vermont Solicitor General Bridget Asay when she told the justices that self-insured plans have incredibly helpful data that could inform state and federal governments' efforts to cut healthcare costs and improve outcomes. "You should have the information. I have no doubt about that," Breyer said, according to the Washington Post.

While Justice Sonia Sotomayor said insurers already compile the type of information Vermont seeks, Liberty Mutual's lawyer said some plans actually only have 70 to 80 percent of what some states' claims databases require, the Post article adds. Instead, states like Vermont should seek such data from healthcare providers, the lawyer said.

The Obama administration and nearly 20 states, however, support Vermont's position, according to the Post. A decision in the case is expected by June.

To learn more:
- here's the AP article
- read the Post's report

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