This page contains Supreme Court rulings -- with summaries of the majority and minority conclusions.
Decided Jun 20, 2002
Case Ruling: Rush Prudential HMO v. Moran
Petitioner Rush Prudential HMO, Inc. provides medical services for employee welfare benefits plans covered by the Employee Retirement Income Security Act (ERISA), denied respondent Moran's request to have surgery on the ground that the procedure was not medically necessary. Moran made a written demand for an independent medical review of her claim, as guaranteed by Illinois' HMO Act. Rush refused her demandHELD: Delivered by Souter, joined by Stevens, O'Connor, Ginsburg, BreyerIn 5-4 decision, justices uphold Illinois state law that requires health maintenance organizations to provide for independent review in disputed cases where physician-prescribed treatment is being denied by HMO. Although Congress has yet to enact a patients' bill of rights that would include the right to independent review, 42 states and the District of Columbia currently have medical review laws. Congress has long recognized that HMOs are risk-bearing organizations subject to state regulation.
Finally, allowing States to regulate the insurance aspects of HMOs will not interfere with the desire of Congress for uniform national standards under ERISA.DISSENT: Dissent by Thomas, joined by Rehnquist, Scalia, KennedyThis Court has repeatedly recognized that ERISA's civil enforcement provision provides the exclusive vehicle for actions asserting a claim for benefits under health plans governed by ERISA, and therefore that state laws that create additional remedies are pre-empted. Such exclusivity of remedies is necessary to further Congress' interest in establishing a uniform federal law of employee benefits so that employers are encouraged to provide benefits to their employees. Independent review provisions could create a disincentive to the formation of employee health benefit plans. This is a judgment that must be made by Congress. I respectfully dissent.
Participating counts on VoteMatch question 5.
Question 5: Expand ObamaCare
Scores: -2=Strongly oppose; -1=Oppose; 0=neutral; 1=Support; 2=Strongly support.
- Topic: Health Care
- Headline: States have authority to protect patient rights
(Score: 2)
- Headline 2: States have no authority to protect patient rights
(Score: -2)
Participating counts on AmericansElect question 3.
- Headline: States have authority to protect patient rights
(Answer: A)
- Headline 2: States have no authority to protect patient rights
(Answer: D)
- AmericansElect Quiz Question 3 on
Healthcare:
When you think about healthcare reform in the United States, which of the following solutions is closest to your opinion?
- A: The Government should be the sole provider of healthcare insurance
- B: The Government should have a major role in providing healthcare insurance
- C: The Government should have a limited role in providing healthcare insurance
- D: Only private companies should provide healthcare insurance
- E: Unsure
- Key for participation codes:
- Sponsorships: p=sponsored; o=co-sponsored; s=signed
- Memberships: c=chair; m=member; e=endorsed; f=profiled; s=scored
- Resolutions: i=introduced; w=wrote; a=adopted
- Cases: w=wrote; j=joined; d=dissented; c=concurred
- Surveys: '+' supports; '-' opposes.
Independents
participating in 02-MORAN |
Total recorded by OnTheIssues:
Democrats:
2
Republicans:
7
Independents:
0 |
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