Rush Prudential HMO, Inc. v. Moran

Rush Prudential HMO, Inc. v. Moran
Supreme Court of the United States
Argued January 16, 2002 Decided June 20, 2002
Full case name	Rush Prudential HMO, Incorporated, Petitioner v. Debra C. Moran, et al.
Citations	536 U.S. 355 (more) 122 S. Ct. 2151; 153 L. Ed. 2d 375; 2002 U.S. LEXIS 4644; 70 U.S.L.W. 4600; 27 Employee Benefits Cas. (BNA) 2921; 15 Fla. L. Weekly Fed. S 409
Case history
Prior	Moran v. Rush Prudential HMO, Inc., No. 98-cv-442, 1999 WL 417384 (N.D. Ill. June 15, 1999); reversed, 230 F.3d 959 (7th Cir. 2000); cert. granted, 533 U.S. 948 (2001).
Holding
ERISA did not preempt an Illinois medical-review statute.
Court membership
Chief Justice William Rehnquist Associate Justices John P. Stevens · Sandra Day O'Connor Antonin Scalia · Anthony Kennedy David Souter · Clarence Thomas Ruth Bader Ginsburg · Stephen Breyer
Case opinions
Majority	Souter, joined by Stevens, O'Connor, Ginsburg, Breyer
Dissent	Thomas, joined by Rehnquist, Scalia, Kennedy
Laws applied
Illinois's Health Maintenance Organization Act Employee Retirement Income Security Act

Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002), was a decision by the Supreme Court of the United States in which the court held that the federal Employee Retirement Income Security Act (ERISA) did not preempt an Illinois medical-review statute.

ERISA envisions a national standard for welfare and pension plans so state laws which "relate to" ERISA plans are preempted under Section 514 of ERISA. However, ERISA contains a "savings" clause which saves state laws which regulate insurance under Section 514(b). The statute at issue in Moran regulated insurance, which is one of the functions HMOs perform. Although HMOs provide healthcare as well as insurance, the statute does not require choosing a single or primary function of an HMO. 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.

This case was partially overruled in Kentucky Ass'n of Health Plans, Inc. v. Miller, 538 U.S. 329 (2003).

External links

• Text of Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002) is available from: CourtListener Google Scholar Internet Archive (docket files) Justia Library of Congress Oyez (oral argument audio)