MARYLAND: Rulings Threaten State Control of Health Plans
Maryland Insurance Commissioner Steven Larsen claims that three federal court rulings last year have encroached on the state's "right to pass and enforce" broad patients' rights legislation. Backed by trade groups representing hospitals, doctors, and insurance agents, Larsen said yesterday that the trend to establish health plan control at the federal level conflicts with the state's efforts to give HMO enrollees the right to appeal care decisions. He also said the rulings require insurers to foot the bill for emergency room visits, clinical drug trials and "90-day supplies of maintenance drugs."
The Baltimore Sun reports that "until recently, federal law had been interpreted to mean that states could regulate health insurance, except for plans in which an employer is self-insured." But over the past year, said Larsen, two cases that struck down patients' rights legislation in Texas and Arkansas have preempted states' authority. Larsen also cited a Maryland case, upheld by the U.S. Supreme Court, which found that the Maryland Insurance Administration could not oversee efforts to "make sure that self-insured plans were truly self-insured, and not attempts to circumvent state regulation." Further, Larsen said, the U.S. Department of Labor issued new regulations which apply to both insured health plans and self-insured plans, muddying the distinction between state and federal authority. Although Larsen did not outline legislation, the Sun reports that state Sens. Thomas Bromwell (D) and Paula Hollinger (D) plan to introduce a measure which would request that Congress assure that states can continue their regulatory role of health plans (Salganik, 2/2).