Kentucky Assn. of Health Plans, Inc. v. Miller, 538 U.S. 329, 6 (2003)

Page:   Index   Previous  1  2  3  4  5  6  7  8  9  10  11  12  13  14  Next

334

KENTUCKY ASSN. OF HEALTH PLANS, INC. v. MILLER

Opinion of the Court

McCarran-Ferguson "checking points," the Sixth Circuit upheld Kentucky's AWP statutes. Ibid.

We granted certiorari, 536 U. S. 956 (2002).

II

To determine whether Kentucky's AWP statutes are saved from pre-emption, we must ascertain whether they are "law[s] . . . which regulat[e] insurance" under § 1144(b)(2)(A).

It is well established in our case law that a state law must be "specifically directed toward" the insurance industry in order to fall under ERISA's saving clause; laws of general application that have some bearing on insurers do not qualify. Pilot Life Ins. Co. v. Dedeaux, 481 U. S. 41, 50 (1987); see also Rush Prudential HMO, Inc. v. Moran, 536 U. S. 355, 366 (2002); FMC Corp. v. Holliday, 498 U. S. 52, 61 (1990). At the same time, not all state laws "specifically directed toward" the insurance industry will be covered by § 1144(b)(2)(A), which saves laws that regulate insurance, not insurers. As we explained in Rush Prudential, insurers must be regulated "with respect to their insurance practices," 536 U. S., at 366. Petitioners contend that Kentucky's AWP laws fall outside the scope of § 1144(b)(2)(A) for two reasons. First, because Kentucky has failed to "specifically direc[t]" its AWP laws toward the insurance industry; and second, because the AWP laws do not regulate an insurance practice. We find neither contention persuasive.

A

Petitioners claim that Kentucky's statutes are not "specifically directed toward" insurers because they regulate not only the insurance industry but also doctors who seek to form and maintain limited provider networks with HMOs. That is to say, the AWP laws equally prevent providers from entering into limited network contracts with insurers, just as they prevent insurers from creating exclusive networks in the first place. We do not think it follows that Kentucky

Page:   Index   Previous  1  2  3  4  5  6  7  8  9  10  11  12  13  14  Next

Last modified: October 4, 2007