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|Any Willing Provider Decision.||HIGH COURT UPHOLDS ANY WILLING PROVIDER LAWS
In a major victory for independent health care providers (including NCPA members) and their patients, the U.S. Supreme Court unanimously has upheld Kentucky’s any willing provider laws. The so-called managed care industry and its allies unsuccessfully argued that any willing provider laws did not regulate insurance, but instead governed employee "benefits" and thus were preempted by ERISA (the Employee Retirement Income Security Act). Since the early 1980s, more than 30 states have enacted any willing provider pharmacy laws based on the NARD/NCPA model law. Kentucky Association of Health Plans Inc. et. al. v. Miller, Commissioner, Kentucky Department of Insurance. (laws.findlaw.com/us/000/00-1471.html).
I sent this e-mail to John Rector, Legal Counsel for the National Community Pharmacy Association.
Does this mean even self-insured plans? Does it totally pre-empt
ERISA? How do Idaho Pharmacists get contracts from those claiming
exemption without having to go to court?
Thanks for your clarification on this age old problem!
In John’s phone call to me he stated self-insured plans do have to comply
with Idaho’s “Patient Pharmacy Preference” (Any Willing Provider) legislation
passed in 1991. When requesting a contract, you only need to refer
to the Kentucky Association of Health Plans Inc. et. al. v. Miller, Commissioner,
Kentucky Department of Insurance case.