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The Role Of Erisa Preemption In Health Reform
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Book Synopsis The Role of ERISA Preemption in Health Reform by :
Download or read book The Role of ERISA Preemption in Health Reform written by and published by . This book was released on with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper examines judicial interpretations of the Employee Retirement Income Security Act (ERISA) and discusses the opportunities to enact health care reform initiatives in light of those interpretations. ERISA is a federal law regulating the administration of private employer-sponsored benefits including health benefits (i.e., health insurance offered by an employer). Because the federal government generally has exercised its authority to pre-empt state regulation of the administration of private employer-sponsored health plans, states are blocked from enforcing laws interfering with ERISA. As many states pursue health care reform experiments, ERISA preemption becomes relevant as a potential limit on the scope and type of reforms states are able to enact. The dominant trend in ERISA litigation has been to pre-empt state legislation and litigation interfering with the administration of private employer-sponsored health plans, making large-scale state health care reform initiatives difficult. This paper discusses: * ERISA's preemption provisions; * ERISA challenges to state regulation of health plans and insurers; * ERISA's potential application in smaller-scale health care regulation; * ERISA and state tort lawsuits; and * Ways ERISA preemption could be changed by Congress or regulatory action. (The paper notes that individual mandates have not yet been litigated under ERISA, but courts are unlikely to find that individual mandates bind administrators and dictate plan choices.) The paper observes that while it is difficult to easily predict what will be pre-empted, there is consistency that emerges over time, which is the return to preemption as a default. Given this trend, the author concludes that states must tread carefully in crafting health care reform initiatives that address the crisis of the uninsured without impermissibly burdening private employers' provision of employee benefit plans. This white paper is part of the Legal Solutions in Health Reform project. It was created by the O'Neill Institute for National and Global Health Law at Georgetown University. The project aims to identify practical, workable solutions to the legal issues that may arise in any upcoming federal health reform debate.
Book Synopsis The role of ERISA Preemption in health reform: opportunities and limits by : Peter D. Jacobson
Download or read book The role of ERISA Preemption in health reform: opportunities and limits written by Peter D. Jacobson and published by . This book was released on with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis ERISA Pre-emption by : William Pierron
Download or read book ERISA Pre-emption written by William Pierron and published by . This book was released on 2008 with total page 14 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States. Congress. House. Committee on Education and Labor. Subcommittee on Labor-Management Relations Publisher : ISBN 13 : Total Pages :114 pages Book Rating :4.F/5 ( download)
Book Synopsis Oversight Hearing on the Effect of ERISA's Preemption Provision on State Health Care Reform by : United States. Congress. House. Committee on Education and Labor. Subcommittee on Labor-Management Relations
Download or read book Oversight Hearing on the Effect of ERISA's Preemption Provision on State Health Care Reform written by United States. Congress. House. Committee on Education and Labor. Subcommittee on Labor-Management Relations and published by . This book was released on 1994 with total page 114 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis ERISA Pre-emption and Health Care Reform by : Michael S. Gordon (deceased)
Download or read book ERISA Pre-emption and Health Care Reform written by Michael S. Gordon (deceased) and published by . This book was released on 2008 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper was originally published in EBRI Issue Brief No. 135, March 1993, during the last major debate on health care reform. It was based on a speech delivered by Michael S. Gordon before the George Washington University National Health Policy Forum's conference on "The Role of Federal Standards in Health Systems Reform: How Much Leash Should ERISA Give the States?" held November 18, 1992. Gordon, now deceased, served under the late Sen. Jacob Javits (R-NY) from 1970-1975 as minority counsel for pensions on the Senate Labor and Public Welfare Committee and assisted in the drafting and enactment of the Employee Retirement Income Security Act (ERISA). Now that the issue of national health care reform has been revived as a topic of debate on Capitol Hill - and along with it the issue of ERISA pre-emption of state health insurance regulation - the Employee Benefit Research Institute is reprinting Gordon's article. Now, as then, his observations provide both historical and fresh perspective on the conflicts over ERISA and federal pre-emption. The complete original publication, "Health Care Reform: Managed Competition and Beyond," EBRI Issue Brief No. 135, March 1993, is available online. The PDF for the above title, published in the May 2007 issue of EBRI Notes, also contains the fulltext of another May 2007 EBRI Notes article abstracted on SSRN: "Income of the Elderly Population Age 65 and Over, 2005."
Book Synopsis The Privatization of Health Care Reform by : M. Gregg Bloche
Download or read book The Privatization of Health Care Reform written by M. Gregg Bloche and published by Oxford University Press. This book was released on 2002-10-17 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: Markets, not politics, are driving health care reform in America today. Inventive entrepreneurs have transformed medicine over the past ten years, and no end to this period of rapid change is in sight. Consumer anxieties over managed care are mounting, and medical costs are again soaring. Meanwhile, the federal government remains mostly on the health policy sidelines, as it has since the collapse of the Clinton administration's campaign for health care reform. This book addresses the changes that the market has wrought- and the challenges this transformation poses for courts and regulators. The law that governs the medical marketplace is an incomplete, overlapping patchwork, conceived mainly without medical care specifically in mind. The ensuing confusion and incoherence are a central theme of this book. Fragmentation of health care lawmaking has foreclosed coordinated, system-wide policy responses, and lack of national consensus on many of the central questions in health care policy has translated into legal contradiction and bitter controversy. Written by leading commentators on American health law and policy, this book examines the widely-perceived failings of managed care and the law's relationship to them. Some of the contributors treat law as a cause of trouble; others emphasize the law's potential and limits as a corrective tool when the market disappoints. The first two chapters present contrasting overviews of how the doctrines and decision-makers that constitute health law work together, for better or worse, to constrain the medical marketplace. The next six chapters address particular market developments and regulatory dilemmas. These include the power of state versus federal government in the health sphere, conflict between insureres and patients and providers over medical need, financial rewards to physicians for frugal practice, the role of antitrust law in the organization of health care provision and financing, the future of public hospitals, and the place of investor-owned versus non-profit institutions. Acknowledging the health sphere's complexities, the authors seek remedies that fit this country's legal, political, and cultural constraints and can contribute to reasoned regulatory goverance. Within limits they believe a measure of rationality is possible.
Book Synopsis ERISA Preemption and State Health Care Reform by :
Download or read book ERISA Preemption and State Health Care Reform written by and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Discusses ERISA, its preemptive affect on state laws, and what type of health care reform would be permissible under ERISA.
Author :United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies Publisher : ISBN 13 : Total Pages :56 pages Book Rating :4.:/5 (51 download)
Book Synopsis ERISA Preemption, Remedies for Denied Or Delayed Health Claims by : United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies
Download or read book ERISA Preemption, Remedies for Denied Or Delayed Health Claims written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 1999 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis ERISA and Health Insurance Subrogation in all 50 States - 5th Edition by : Gary L. Wickert
Download or read book ERISA and Health Insurance Subrogation in all 50 States - 5th Edition written by Gary L. Wickert and published by Juris Publishing, Inc.. This book was released on 2013-01-01 with total page 1300 pages. Available in PDF, EPUB and Kindle. Book excerpt: ERISA and Health Insurance Subrogation In All 50 States is the most complete and thorough treatise covering the complex subject of ERISA and health insurance subrogation ever published. NEW TO THE FIFTH EDITION! • Updated To Include All The Newest Case Law! • Updated To Include Medicaid Subrogation and Preemption of FEHBA ! • New Plan Language Recommendations! • Complete Health Insurance Subrogation Laws In All 50 States • Covers The Application of ERISA In Every Federal Circuit The Fifth Edition of ERISA and Health Insurance Subrogation In All 50 States has been completely revised, edited, and reorganized. This was partly to reflect the new direction recent case decisions have taken regarding health insurance subrogation as well as the crystallization of formerly uncertain and nebulous areas of the law which have now received some clarity. An entirely new chapter entitled, “What Constitutes Other Appropriate Equitable Relief?” has been added and replaces the old Chapter 9, which merely dealt with Knudson and Sereboff. The new edition introduces new state court decisions addressing the issue of causation and whether and when a subrogated Plan seeking reimbursement must prove that the medical benefits it seeks to recover were causally related to the original negligence of the tortfeasor. An entirely new section was added concerning the subrogation and reimbursement rights of Medicare Advantage Plans, a statutorily-authorized Plan which provides the same benefits an individual is entitled to recover under Medicare. This includes recent case law which detrimentally affects the rights of such Plans to subrogate. Also added to the new edition is additional law and explanation regarding Medicaid subrogation, including the differentiation between “cost avoidance” and “pay and chase” when it comes to procedures for paying Medicaid claims. Significant improvements have been made to suggested Plan language which maximizes a Plan’s subrogation and reimbursement rights. The suggested language stems from recent decisions and developments in ERISA and health insurance subrogation from around the country since the last edition. The new edition has been completely reworked both in substance and organization. Recent case law has necessitated consolidation of several portions of the book and elimination or editing of others. A new section entitled “Liability of Plaintiff’s Counsel” has been added, which provides a clearer exposition on the laws applicable and remedies available when plaintiff’s attorneys and Plan beneficiaries settle their third-party cases and fail to reimburse the Plan. Also new to the book are recently-passed anti-subrogation measures such as Louisiana’s Senate Bill 169, § 1881, which states that no health insurer shall seek reimbursement from automobile Med Pay coverage without first obtaining the written consent of the insured. The new edition also goes into much greater detail on the procedures for and law underlying the practice of removal of cases from state court to federal court, and the possibility of remand back to state court. This includes the Federal Courts Jurisdiction and Venue Clarification Act of 2011, effective Jan. 6, 2012, which amended federal removal, venue, and citizenship determination statutes in very significant ways. The new edition also delves into, for the first time, the role which the federal Anti-Injunction Act plays when beneficiaries sue in state court to enforce the terms of an ERISA Plan, while the Plan files suit in federal court seeking an injunction against the state court action. New case law and discussion on preemption of FEHBA subrogation and reimbursement claims have been added to Chapter 10 in the wake of new decisions regarding same.
Book Synopsis Employer-based Health Plans by : United States. General Accounting Office
Download or read book Employer-based Health Plans written by United States. General Accounting Office and published by . This book was released on 1995 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States. Congress. House. Committee on Education and the Workforce. Subcommittee on Employer-Employee Relations Publisher : ISBN 13 : Total Pages :160 pages Book Rating :4.F/5 ( download)
Book Synopsis ERISA, a Quarter Century of Providing Workers Health Insurance by : United States. Congress. House. Committee on Education and the Workforce. Subcommittee on Employer-Employee Relations
Download or read book ERISA, a Quarter Century of Providing Workers Health Insurance written by United States. Congress. House. Committee on Education and the Workforce. Subcommittee on Employer-Employee Relations and published by . This book was released on 1999 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Legal Issues Relating to State Health Care Regulation by : Jon O. Shimabukuro
Download or read book Legal Issues Relating to State Health Care Regulation written by Jon O. Shimabukuro and published by . This book was released on 2008 with total page 15 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report provides an overview of the Employee Retirement Income Security Act (ERISA) preemption, discusses legal challenges to fair share laws, and analyzes the fair share requirements included as part of the Massachusetts Health Care Reform Act.
Author :United States. Congress. House. Committee on Education and Labor. Subcommittee on Labor-Management Relations Publisher : ISBN 13 : Total Pages :216 pages Book Rating :4.F/5 ( download)
Book Synopsis ERISA by : United States. Congress. House. Committee on Education and Labor. Subcommittee on Labor-Management Relations
Download or read book ERISA written by United States. Congress. House. Committee on Education and Labor. Subcommittee on Labor-Management Relations and published by . This book was released on 1982 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis ERISA Preemption of State 'Play Or Pay' Mandates by : Mary Ann Chirba-Martin
Download or read book ERISA Preemption of State 'Play Or Pay' Mandates written by Mary Ann Chirba-Martin and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Although ERISA preemption was ranked among the top "eight pertinent issues" that needed to be addressed in order to achieve comprehensive health care reform, Congress opted to avoid it when it passed the Patient Protection and Affordable Health Care Act on March 23, 2010, and the Health Care and Education Reconciliation Act just one week later ("PPACA" or the "Act," collectively). Currently 180 million Americans receive employer-sponsored health benefits, and millions more will do so once PPACA takes full effect over the next few years. This expansion of employer based coverage, coupled with what the Act does and does not do regarding the role of employers, makes ERISA preemption potentially more problematic than ever. Thus, to accomplish meaningful improvements in how employer-sponsored health benefits are financed and delivered, Congress must tackle ERISA preemption of state "play or pay" laws if it expects to improve instead of simply expand and exacerbate existing problems with employer coverage.
Author :United States. Congress. House. Committee on Education and Labor. Subcommittee on Health, Employment, Labor, and Pensions Publisher : ISBN 13 : Total Pages :72 pages Book Rating :4.0/5 ( download)
Book Synopsis Health Care Reform by : United States. Congress. House. Committee on Education and Labor. Subcommittee on Health, Employment, Labor, and Pensions
Download or read book Health Care Reform written by United States. Congress. House. Committee on Education and Labor. Subcommittee on Health, Employment, Labor, and Pensions and published by . This book was released on 2007 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Erisa Preemption by : Lorraine A. Schmall
Download or read book Erisa Preemption written by Lorraine A. Schmall and published by . This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The dissatisfaction with the Court's broad interpretation of the preemption provisions of ERISA, without specifically articulating what remedies existed to replace preempted state remedies, has been often brought to the attention of Congress by those who believed that the Court's construction of the preemption provisions of ERISA, without a recognition of some rights and remedies to take the place of preempted state rights and remedies, went beyond what the Congress intended. But the Supreme Court may never have intended for ERISA to preempt health care claims in most instances, and recently reiterated: "in the field of health care, a subject of traditional state regulation, there is no ERISA preemption without clear manifestation of congressional purpose." Federal and state courts have followed that lead by finding ways for state laws to protect their citizens. Apparently, there is a medical malpractice crisis which is caused by too much malpractice by doctors, too greedy plaintiffs, or unwarranted but uncontrolled insurance premiums. But this paper is concerned with how patients who have suffered from poor or inadequate medical care can seek redress. Health care costs continue to skyrocket, and one of the concomitants of cost containment is the creation of legal hurdles for patients who have been injured by a failure to provide, or negligent provision of, health care. Since most health insurance is tied to employment, ERISA, the federal law that regulates all employee benefit plans, including health insurance, complicates patients' medical malpractice claims. Many federal courts have concluded that if the quality or denial of care is considered part of the administration an employee benefit plan, all state actions may be preempted. If an employee wants to bring a claim against the physician or the managed health care organization, the employee must consider whether the claim will fall under state law, or whether the state cause of action will be preempted by ERISA. Because state law may offer employees greater protections than ERISA, broad federal preemption of state law under ERISA is also a part of the problem for an employee seeking protection against employer discharges and other acts that interfere with her rights to benefits. Rather than wait for Congress to amend a complicated tax and labor statute, plaintiffs can begin to look toward resolution in state common and statutory law.
Author :United States. Congress. House. Committee on Economic and Educational Opportunities. Subcommittee on Employer-Employee Relations Publisher : ISBN 13 : Total Pages :120 pages Book Rating :4.3/5 (121 download)
Book Synopsis Hearing on Health Care Reform by : United States. Congress. House. Committee on Economic and Educational Opportunities. Subcommittee on Employer-Employee Relations
Download or read book Hearing on Health Care Reform written by United States. Congress. House. Committee on Economic and Educational Opportunities. Subcommittee on Employer-Employee Relations and published by . This book was released on 1995 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt:
