Rush Prudential HMO, Inc. v. Moran

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Rush Prudential HMO, Inc. v. Moran

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; 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

Prior history:	On writ of certiorari to the United States Court of Appeals for the Seventh Circuit

Holding

Court membership

Chief Justice: William Rehnquist
Associate Justices: John Paul Stevens, Sandra Day O'Connor, Antonin Scalia, Anthony Kennedy, David Souter, Clarence Thomas, Ruth Bader Ginsburg, Stephen Breyer

Case opinions

Majority by: Souter
Joined by: Stevens, O'Connor, Ginsburg, Breyer
Dissent by: Thomas
Joined by: Rehnquist, Scalia, Kennedy

Laws applied

Illinois's Health Maintenance Organization Act

Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355 (2002)^[1], was a case in which the Supreme Court ruled. It decided that ERISA does not preempt the 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.