Yet Another Health Care Battle

State Legislatures, December 1995 | Go to article overview

Yet Another Health Care Battle


Managed care organizations are fighting yet another court battle against state regulation. This time the arena is Arkansas and the contenders are Prudential Insurance Company vs. Governor Jim Guy Tucker, the attorney general, the insurance commissioner and the director of the Department of Health. The fight is over Arkansas' "any-willing-provider" legislation.

The governor reluctantly signed one of the nation's broadest any-willing-provider laws, the Patient Protection Act of 1995, on March 1. Overwhelmingly passed by Arkansas legislators (33-1 in the Senate and 88-1 in the House), it says health maintenance organizations (HMOs) may not limit the participation of qualified health care providers if they are willing to accept the plan's contracts and fee schedules.

The law, which went into effect .in July, was seen as a victory for provider organizations like the Arkansas Medical Society and a loss for the managed health care industry. Managed care constitutes about 22 percent of the Arkansas market.

Prudential and its co-plaintiffs, HMO Partners Inc., Tyson Foods, the Arkansas AFL-CIO and the United Paperworkers International Union, claim that the state law is preempted by the Employee Retirement Income Security Act of 1974 [ERISA], the federal Health Maintenance Organization Act and the federal Employee Health Benefit Act. They also contend that it violates the Commerce Clause of the U.S. Constitution. The Prudential Health Care System serves more than 8,000 HMO members in Arkansas and 4.5 million nationwide.

"We believe the legislation violates a number of federal statutes and interferes with our ability to work with employers to provide people with their choice of competing health plans," said Norine Yukon, executive director of Prudential Health Care System of Arkansas.

Arkansas Blue Cross/Blue Shield also filed a lawsuit against several doctors and hospitals who demanded entrance to their managed care networks under the provisions of the Patient Protection Act. "We want the courts to confirm what the law [ERISA] really says so we can conduct business accordingly without fear of the penalties imposed under the any-willing-provider law. By getting this question resolved now, we won't be subject to lawsuits on these issues in the future," said Robert D. Cabe, an executive with Arkansas BC/BS.

The federal government enacted ERISA to help establish uniform federal standards for the protection of private employee pension plans. ERISA affects state policymaking because its "preemption clause" makes void all state laws relating to self-insured employee health plans. Arkansas legislators addressed the ERISA conflict with follow-up HB 1826, which excludes from the Patient Protection Act self-funded or other health benefit plans that are exempt from state regulation by virtue of ERISA. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Yet Another Health Care Battle
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.