STATE
INDEPENDENT MEDICAL REVIEW OF CLAIM DENIALS NOT PREEMPTED -
RUSH PRUDENTIAL V. MORAN
In
Rush Prudential HMO, Inc. v. Moran (2002) 02 CDOS 5464, the U.S.
Supreme Court held that Illinois law giving patients a right to an
independent medical review of claim denials by an HMO was not preempted by
ERISA. The Court held that the Illinois law was “saved” from preemption
by federal law because the state statute regulates insurance.
Rush Prudential
v. Moran
validates state laws that impose the right to an independent medical
review of claim denials by HMO’s regulated under ERISA.
