Gobeille v. Liberty Mutual: Everything You Need to Know

In a 6-2 decision in Gobeille v. Liberty Mutual released on March 1, the U.S. Supreme Court has dealt a blow to state all- payer claims databases. By upholding a lower court’s decision, the Court ruled that states may no longer require self funded plans to submit claims data – that action is preempted by ERISA.

NASHP Executive Director Trish Riley published a blog outlining what the decision means for states.

What was at issue?
At issue was whether or not a state can compel a self-insured employer to submit health care claims – data that shows how much was paid for health care services – to the state’s APCD.

Is Vermont the only state with APCD?
Currently 18 states have enacted laws to create APCD and 20 more are considering doing so.

What does this mean for states?
This case could have a chilling effect on APCD and the critical analysis regarding the costs and quality that they enable- if the court rules that self-insured employers need not provide data to those programs.
A decision against Vermont’s APCD will likely weaken an important and still evolving tool states have to guide their reforms – independent, complete claims data that includes all payers, whether regulated by the state or the federal government.

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