[T]he U.S. Supreme Court has agreed to hear Vermont’s appeal of a federal circuit court ruling that exempts self-insured companies from reporting health care claims data to the state, the court announced Monday.
The 2nd Circuit Court of Appeals in New York ruled in January 2014 that Liberty Mutual, which offers self-insured health benefit plans to its employees, should not have to report its claims data to Vermont, citing a provision of the Employee Retirement Income Security Act (ERISA).
Claims data collected by the state is fed into a database that is intended to be a comprehensive source for all health care payments in Vermont, from government programs as well as from individuals and private insurers — including self-insured companies covered by ERISA.
About 100,000 Vermonters work for self-insured companies, or just under one-sixth of the state’s population. The 2nd Circuit ruling reversed a district court decision that had directed Liberty Mutual to submit its data or pay a penalty of up to $10,000 per infraction.
Vermont is among several states, mostly in New England, working to build so-called all-payer claims databases to better assess health care spending, service quality and access. In Vermont the database is known as the Vermont Health Care Uniform Reporting and Evaluation System, or VHCURES.
Attorney General Bill Sorrell’s office petitioned the U.S. Supreme Court to review the case in August 2014. The U.S. Department of Justice filed a brief with the Supreme Court siding with Vermont. The case will likely be heard in late fall and decided before the Supreme Court’s next term ends in June 2016.
The outcome of this case is important because it could set precedent around any state’s ability to compile all payments made to the health care system within its borders.
The move surprised many Supreme Court watchers, according to Bloomberg News, because the U.S. Solicitor General advised the high court to wait until other federal courts consider similar databases before taking on the dispute itself. Rejecting the solicitor’s recommendation after specifically asking for it is a departure from the court’s recent practice in ERISA cases, Bloomberg reported.
Sorrell issued a statement praising the court’s decision to take up the case.
“We are committed to defending Vermont’s authority to gather the information it needs to make sound decisions about health care policy,” he said.
Al Gobeille, chair of the regulatory Green Mountain Care Board, praised the decision as well, touting VHCURES’ importance to Vermont’s health reform efforts.
“Health care policy should be grounded in good research and solid data. VHCURES is a critical tool for the Board and for Vermont as we make important decisions about the future of our health care system,” he said in a statement.
A Liberty Mutual spokesman said in a statement that the company “looks forward to the Supreme Court’s review of this issue.”
