![]() ![]() A key factual dispute exists concerning a central issue in this case. On this record, we hold that the trial court erred by entering summary judgment for the defendant plans based on ERISA preemption. Here, a health-care provider sued defendant health-insurance plans, which are governed by ERISA, alleging they failed to pay agreed reimbursement rates for covered services under their plans. A claim withstands preemption to the extent its validity turns not on the meaning of the plan documents but on a separate legal duty independent of the plan. Some state laws-and hence the claims arising under such laws-survive ERISA preemption, such as those not requiring interpretation of benefit-plan documents. These provisions’ preemptive effect on state laws is far-reaching but not absolute. To further the goal of uniform federal standards, ERISA contains two preemption provisions. ![]() Under ERISA, the responsibility for regulating this system of benefit plans is exclusively a federal concern. The Employee Retirement Income Security Act of 1974 establishes minimum federal standards governing employee-benefit plans. 18A-PL-1349 Opinion by Justice Slaughter Chief Justice Rush and Justices Massa and Goff concur. Hostetler, Judge On Petition to Transfer from the Indiana Court of Appeals Case No. Argued: Octo| Decided: Appeal from the St. 20S-PL-302 FMS Nephrology Partners North Central Indiana Dialysis Centers, LLC, Appellant, –v– Meritain Health, Inc., et al., Appellees. The Supreme Court vacated the judgment, holding that genuine issues of disputed fact existed concerning the central issue of whether the provider's claims were denied coverage under the plans or whether the provider's claims necessitated interpreting the plan documents.įILED May 11 2020, 3:27 pm CLERK Indiana Supreme Court Court of Appeals and Tax Court IN THE Indiana Supreme Court Supreme Court Case No. The trial court granted summary judgment against Plaintiff, concluding that Plaintiff's claims were preempted under ERISA's conflict-preemption provision, 29 U.S.C. Plaintiff sued Defendants, alleging that they failed to pay agreed reimbursement rates for covered services under their plans. Seven patients received treatments from Plaintiff, and the patients were covered under Defendants' plans. Defendants and its affiliated employee health-insurance plans contacted with both health networks. Plaintiff, a health-care provider, contracted with two third-party networks. ![]() The Supreme Court vacated the trial court's grant of summary judgment for Defendants, holding that the trial court erred by entering summary judgment for defendant health-insurance plans, which were governed by the Employee Retirement Income Security Act of 1974 (ERISA), based on ERISA preemption. ![]()
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