CHICAGO, June 12, 2024 — The American Dental Association (ADA) filed an amicus (friend of the court) brief to the United States Supreme Court seeking review of a decision from the U.S. Tenth Circuit Court of Appeals concerning the overly broad application of so-called ERISA preemption of state statutes directed to administrative aspects of self-funded health care plans. Last year, the Tenth Circuit decided against the state of Oklahoma and, in doing so, took a very expansive view of ERISA preemption despite the recent Supreme Court decision in Rutledge v. Pharmaceutical Care Management Association that makes it clear ERISA preemption is not extensive. The ADA brief supports the state of Oklahoma’s position that state laws such as the one it passed should not be preempted by ERISA.
The Employee Retirement Income Security Act of 1974 (ERISA) regulates the administration of employee benefit plans, including dental care. However, some insurance carriers administering self-funded plans argue that since ERISA is a federal law, it supersedes, or ‘preempts’ state insurance laws that protect patients and providers. In the Amicus brief, the ADA and other health care providers ask the Supreme Court to review a case to clarify a lower court’s ruling to stop insurers from taking an unfair advantage of ERISA’s authority and to comply with the state laws officials pass and enforce in the US.
“We believe that the Supreme Court should consider this case because the Appellate Court’s opinion appears to introduce confusion and inconsistency in an area the Supreme Court recently attempted to clarify and make uniform in a different case,” said Linda Edgar, D.D.S., president of the American Dental Association. “The ADA and numerous health care organizations urge the Court to take the opportunity to reemphasize its holding in Rutledge before other lower court decisions further muddy the waters,” Dr. Edgar said.
The amicus brief, which was submitted along with a coalition of health care provider organizations, will support the Petition for Certiorari, which seeks Supreme Court review of a decision from the Tenth Circuit Court of Appeals. The coalition believes the 10th Circuit’s decision takes an overly expansive view of ERISA preemption and conflicts with the Supreme Court decision, Rutledge v. Pharmaceutical Care Management Association, that appropriately limits the reach of the federal ERISA statute’s preemption.
The American Dental Association, The American Optometric Association, American Association of Orthodontics, American Academy of Pediatric Dentists, The Association of Dental Support Organizations, American Association of Oral and Maxillofacial Surgeons and other groups believe that it is in the best interest of patient protections and providers that state laws requiring third-party payors must honor the laws passed in their state if not directly associated with plan administration.
The brief explains how the 10th Circuit’s overly broad interpretation of ERISA preemption reintroduces the very confusion that the Rutledge decision eliminates. The regulation of insurance and health care quality are parts of the historic powers reserved for the states and not the federal government. If states cannot enforce laws regarding how health care is provided and paid for, then no one can.
“Unless the 10th Circuit’s decision is addressed, ERISA plans will continue to take the position that they are not subject to pro-patient and pro-provider state laws,” said Dr. Edgar. “This leaves consumers lacking protection and vulnerable to potentially abusive practices of insurers.”
The amicus brief supports the Supreme Court’s elimination of the confusion and inconsistency in the area of ERISA preemption the Court accomplished in the Rutledge decision. It supports states’ traditional authority to regulate health care and insurance.
For more information on the topic visit ADA.org/ERISA.