Supreme Court To Hear Case Deciding Fate of All-Payers Claims Databases

On Wednesday, the U.S. Supreme Court is scheduled to hear arguments in a data-rights case that could influence the success or failure of many states’ all-payer claims databases.

The Vermont-based Gobeille v. Liberty Mutual Insurance case would decide whether a self-funded health insurer has to give claims data, enrollee eligibility and other information to state health officials.

So far 18 states have set up state-sponsored all-payer claims databases, and roughly 20 more are considering that kind of legislation — including California.  Some legislators and policymakers consider the databases important tools to improve care and reduce costs.

SB 26, by Sen. Ed Hernandez (D-West Covina), would establish a statewide claims database; it was introduced in December 2014 and was held on suspense file in the Senate Committee on Appropriations in May 2015. It could be advanced when the Legislature reconvenes Jan. 2, depending in part on when the Supreme Court rules on it.

Liberty Mutual has said it is exempt from submitting that data, under the rules of the federal Employee Retirement Income Security Act (ERISA), which would pre-empt state data collection law, Liberty Mutual lawyers said.  

State officials in Vermont disagree, and said they need that data to improve consumers’ health outcomes by analyzing health care costs, quality and access.

The 2nd U.S. Circuit Court of Appeals ruled in Liberty Mutual’s favor.

A decision is expected by June 2016, when the current Supreme Court term ends.

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