new
york
state
blue
cross
plans
travelers
argued
january
decided
april
page
together
pataki
governor
new
york
et
al
travelers
insurance
et
hospital
association
new
york
state
travelers
insurance
et
also
certiorari
new
york
statute
requires
hospitals
collect
surcharges
patients
covered
commercial
insurer
patients
insured
blue
shield
plan
also
subjects
certain
health
maintenance
organizations
hmos
surcharges
several
commercial
insurers
trade
associations
filed
actions
state
officials
claiming
employee
retirement
income
security
act
erisa
state
laws
relate
covered
employee
benefit
plan
superseded
imposition
surcharges
bills
patients
whose
commercial
insurance
coverage
purchased
erisa
plan
hmos
insofar
membership
fees
paid
erisa
plan
blue
shield
plans
collectively
blues
hospital
association
intervened
defendants
several
hmos
hmo
conference
intervened
plaintiffs
district
consolidated
actions
granted
plaintiffs
summary
judgment
appeals
affirmed
relying
decisions
shaw
delta
air
lines
district
columbia
greater
washington
board
trade
holding
erisa
clause
must
read
broadly
reach
state
law
connection
reference
covered
benefit
plans
decided
surcharges
meant
increase
costs
certain
insurance
hmo
health
care
held
purposeful
interference
choices
erisa
plans
make
health
care
coverage
constitutes
connection
erisa
plans
triggering
page
ii
held
new
york
surcharge
provisions
relate
employee
benefit
plans
within
meaning
thus
pp
shaw
supra
provisions
relate
erisa
plans
connection
make
reference
plans
clearly
make
reference
erisa
plans
erisa
text
unhelpful
determining
whether
connection
thus
must
look
erisa
objectives
guide
scope
state
law
congress
understood
survive
pp
basic
thrust
clause
avoid
multiplicity
regulation
order
permit
nationally
uniform
administration
employee
benefit
plans
thus
erisa
state
laws
mandate
employee
benefit
structures
administration
well
provide
alternate
enforcement
mechanisms
purpose
effects
new
york
statute
quite
different
however
principal
reason
charge
differentials
blues
provide
coverage
many
subscribers
commercial
insurers
reject
since
differentials
make
blues
attractive
indirect
economic
effect
choices
made
insurance
buyers
including
erisa
plans
however
indirect
economic
influence
bind
plan
administrators
particular
choice
preclude
uniform
administrative
practice
provision
uniform
interstate
benefit
package
simply
bears
costs
benefits
relative
costs
competing
insurance
provide
cost
uniformity
almost
certainly
object
rate
differentials
common
even
absence
state
action
therefore
unlikely
erisa
meant
bar
indirect
influences
state
law
existence
common
state
actions
indirect
economic
effects
plan
cost
quality
control
standards
workplace
regulation
leaves
intent
even
less
likely
since
laws
superseded
well
new
york
surcharges
leave
plan
administrators
case
responsibility
choose
best
overall
coverage
money
thus
bear
requisite
connection
erisa
plans
trigger
pp
conclusion
confirmed
decision
mackey
lanier
collection
agency
service
erisa
falls
short
barring
application
general
state
garnishment
statutes
participants
benefits
hands
erisa
plan
new
york
surcharges
impose
kind
substantive
coverage
requirement
binding
plan
administrators
issue
metropolitan
life
insurance
massachusetts
since
require
plans
deal
one
insurer
insure
entire
category
illnesses
plans
might
otherwise
choose
cover
pp
conclusion
one
drawn
unsettling
result
barring
state
regulation
hospital
costs
theory
laws
indirect
economic
effects
erisa
plans
however
hint
erisa
legislative
history
page
iii
elsewhere
congress
intended
squelch
efforts
several
regulating
hospital
charges
degree
time
erisa
passed
moreover
broad
interpretation
rendered
nugatory
entire
federal
statute
enacted
erisa
congress
gave
comprehensive
aid
state
health
care
rate
regulation
pp
reaching
decision
hold
erisa
direct
regulation
erisa
plans
possible
state
law
might
produce
acute
albeit
indirect
economic
effects
force
erisa
plan
adopt
certain
scheme
coverage
effectively
restrict
choice
insurers
case
souter
delivered
opinion
unanimous
new
york
state
blue
cross
plans
travelers
justice
souter
delivered
opinion
new
york
statute
requires
hospitals
collect
surcharges
patients
covered
commercial
insurer
patients
insured
blue
shield
plan
subjects
certain
health
maintenance
organizations
hmos
surcharges
vary
number
medicaid
recipients
enrolls
pub
health
law
mckinney
case
calls
us
decide
whether
employee
retirement
income
security
act
erisa
stat
amended
new
york
state
blue
cross
plans
travelers
et
seq
ed
supp
state
provisions
surcharges
bills
patients
whose
commercial
insurance
coverage
purchased
employee
plans
governed
erisa
surcharges
hmos
insofar
membership
fees
paid
erisa
plan
hold
provisions
surcharges
relate
employee
benefit
plans
within
meaning
erisa
provision
accordingly
suffer
new
york
prospective
hospital
reimbursement
methodology
nyphrm
regulates
hospital
rates
care
except
services
provided
medicare
beneficiaries
pub
health
law
mckinney
scheme
calls
patients
charged
cost
individual
treatment
average
cost
treating
patient
medical
problem
classified
one
another
diagnostic
related
groups
drgs
charges
allowable
accordance
drg
classifications
adjusted
specific
hospital
reflect
particular
operating
costs
capital
investments
bad
debts
costs
charity
care
like
patients
blue
shield
coverage
medicaid
patients
hmo
participants
billed
hospital
drg
rate
pub
health
law
see
also
brief
petitioners
pataki
et
others
however
patients
served
commercial
insurers
providing
hospital
coverage
basis
funds
directly
reimbursing
hospitals
certain
workers
compensation
new
york
state
blue
cross
plans
travelers
volunteer
firefighters
benefit
ambulance
workers
benefit
motor
vehicle
insurance
funds
must
billed
drg
rate
plus
surcharge
retained
hospital
pub
health
law
year
ending
march
moreover
hospitals
required
bill
commercially
insured
patients
surcharge
turned
state
result
patients
charged
drg
rate
new
york
law
also
imposes
surcharge
hmos
varies
depending
number
eligible
medicaid
recipients
hmo
enrolled
may
run
high
aggregate
monthly
charges
paid
hmo
members
hospital
care
assessment
increase
rates
paid
hmo
hospitals
direct
payment
hmo
state
general
fund
erisa
comprehensive
regulation
employee
welfare
pension
benefit
plans
extends
provide
medical
surgical
hospital
care
benefits
plan
participants
beneficiaries
purchase
insurance
otherwise
federal
statute
go
protecting
plan
participants
beneficiaries
requiring
employers
provide
given
set
minimum
benefits
instead
controls
administration
benefit
plans
see
imposing
reporting
disclosure
mandates
participation
vesting
requirements
funding
standards
fiduciary
responsibilities
plan
administrators
envisions
administrative
oversight
imposes
criminal
sanctions
establishes
comprehensive
civil
enforcement
scheme
also
state
law
section
provides
erisa
shall
supersede
state
laws
insofar
relate
employee
benefit
plan
covered
new
york
state
blue
cross
plans
travelers
statute
although
stops
short
law
state
regulates
insurance
exception
insurance
regulation
limited
however
provision
employee
welfare
benefit
plan
may
deemed
insurance
company
insurer
engaged
business
insurance
finally
erisa
saves
generally
applicable
criminal
law
state
new
york
state
blue
cross
plans
travelers
claimed
authority
erisa
general
provision
several
commercial
insurers
acting
fiduciaries
erisa
plans
administer
joined
trade
associations
bring
actions
state
officials
district
seeking
invalidate
surcharge
statutes
new
york
state
conference
blue
cross
blue
shield
plans
empire
blue
cross
blue
shield
collectively
blues
hospital
association
new
york
state
intervened
defendants
new
york
state
health
maintenance
organization
conference
several
hmos
intervened
plaintiffs
district
consolidated
actions
granted
summary
judgment
plaintiffs
supp
sdny
found
although
surcharges
directly
increase
plan
costs
ffect
level
benefits
offered
little
doubt
urcharges
issue
significant
effect
commercial
insurers
hmos
provide
coverage
erisa
plans
thus
lead
least
indirectly
increase
plan
costs
omitted
found
entire
justification
urcharges
premised
exact
result
urcharges
increase
cost
obtaining
medical
insurance
source
blues
sufficient
extent
customers
switch
coverage
ensure
economic
viability
blues
ibid
omitted
district
concluded
effect
choices
erisa
plans
enough
trigger
surcharges
saved
regulating
insurance
district
accordingly
enjoined
enforcement
surcharges
commercial
insurers
hmos
connection
coverage
erisa
plans
new
york
state
blue
cross
plans
travelers
appeals
second
circuit
affirmed
relying
decisions
shaw
delta
air
lines
district
columbia
greater
washington
board
trade
holding
erisa
clause
must
read
broadly
reach
state
law
connection
reference
covered
employee
benefit
plans
light
decision
mcclendon
appeals
abandoned
prior
decision
rebaldo
cuomo
cert
denied
drawn
upon
definition
term
state
erisa
conclude
state
law
must
purport
regulate
terms
conditions
employee
benefit
plans
fall
within
preemption
provision
erisa
internal
quotation
marks
omitted
rejecting
narrower
approach
erisa
relied
statement
applicable
broad
meaning
state
law
may
relate
benefit
plan
thereby
even
law
specifically
designed
affect
plans
effect
indirect
see
new
york
state
blue
cross
plans
travelers
appeals
agreed
trial
surcharges
meant
increase
costs
certain
insurance
health
care
hmos
held
purpose
ful
interfer
ence
choices
erisa
plans
make
health
care
coverage
sufficient
constitute
connection
erisa
plans
triggering
conclusion
sum
three
surcharges
relate
erisa
impose
significant
economic
burden
commercial
insurers
hmos
therefore
impermissible
impact
erisa
plan
structure
administration
light
conclusion
surcharge
statutes
otherwise
saved
applicable
exception
held
recognized
apparent
conflict
conclusion
decision
third
circuit
wire
metal
machine
health
welfare
fund
morristown
memorial
cert
denied
held
new
jersey
similar
rate
setting
statute
relate
plans
way
triggers
erisa
preemption
clause
see
granted
certiorari
resolve
conflict
reverse
remand
new
york
state
blue
cross
plans
travelers
ii
since
claims
turn
congress
intent
cipollone
supra
slip
shaw
supra
begin
exercise
statutory
construction
text
provision
question
move
need
structure
purpose
act
occurs
see
governing
text
erisa
clearly
expansive
section
marks
state
laws
insofar
relate
employee
benefit
plan
covered
erisa
one
might
excused
wondering
first
blush
whether
words
limitation
insofar
new
york
state
blue
cross
plans
travelers
relate
much
limiting
relate
taken
extend
furthest
stretch
indeterminacy
practical
purposes
never
run
course
eally
universally
relations
stop
nowhere
james
roderick
hudson
xli
new
york
world
classics
course
read
congress
words
limitation
mere
sham
read
presumption
law
whenever
congress
speaks
matter
generality
said
recognize
prior
attempt
construe
phrase
relate
give
us
much
help
drawing
line
shaw
explained
law
relates
employee
benefit
plan
normal
sense
phrase
connection
reference
plan
latter
alternative
least
ruled
surcharges
imposed
upon
patients
hmos
regardless
whether
commercial
coverage
membership
respectively
ultimately
secured
erisa
plan
private
purchase
otherwise
consequence
surcharge
statutes
said
make
reference
erisa
plans
manner
cf
greater
bd
trade
slip
striking
district
columbia
law
specifically
refers
welfare
benefit
plans
regulated
erisa
basis
alone
still
leaves
us
question
whether
surcharge
laws
connection
erisa
plans
uncritical
literalism
help
trying
construe
relate
reasons
infinite
relations
measure
neither
infinite
connections
simply
must
go
beyond
unhelpful
text
frustrating
difficulty
defining
key
term
look
instead
objectives
erisa
statute
guide
scope
state
law
congress
understood
survive
new
york
state
blue
cross
plans
travelers
said
indicates
congress
intent
establish
regulation
employee
welfare
benefit
plans
exclusively
federal
concern
alessi
found
passing
congress
intended
ensure
plans
plan
sponsors
subject
uniform
body
benefits
law
goal
minimize
administrative
financial
burden
complying
conflicting
directives
among
federal
government
prevent
potential
conflict
substantive
law
requiring
tailoring
plans
employer
conduct
peculiarities
law
jurisdiction
accordingly
shaw
example
trouble
finding
new
york
human
rights
law
prohibit
ed
employers
structuring
employee
benefit
plans
manner
discriminate
basis
pregnancy
new
york
disability
benefits
law
require
employers
pay
employees
specific
benefits
clearly
relate
benefit
plans
mandates
affecting
coverage
honored
varying
subjects
plan
benefits
whenever
new
york
law
might
applied
requiring
every
plan
new
york
state
blue
cross
plans
travelers
provide
beneficiaries
benefit
demanded
new
york
law
new
york
law
said
require
one
beneficiary
similarly
pennsylvania
law
prohibited
plans
requiring
reimbursement
beneficiary
event
recovery
third
party
related
employee
benefit
plans
within
meaning
fmc
holliday
law
prohibit
ed
plans
structured
manner
requiring
reimbursement
event
recovery
third
party
require
plan
providers
calculate
benefit
levels
pennsylvania
based
expected
liability
conditions
differ
enacted
similar
antisubrogation
legislation
thereby
frustrat
ing
plan
administrators
continuing
obligation
calculate
uniform
benefit
levels
nationwide
ibid
pennsylvania
employees
recovered
negligence
actions
tortfeasors
virtue
state
law
effect
entitled
benefits
excess
plan
administrators
intended
provide
excess
plan
provided
employees
along
lines
new
jersey
prohibit
plans
setting
workers
compensation
payments
employees
retirement
benefits
pensions
prevent
plans
using
method
calculating
benefits
permitted
federal
law
alessi
supra
cases
erisa
state
laws
mandated
employee
benefit
structures
administration
elsewhere
held
state
laws
providing
alternate
enforcement
mechanisms
also
relate
erisa
plans
triggering
see
supra
new
york
state
blue
cross
plans
travelers
purpose
effects
new
york
surcharge
statutes
distinguish
examples
given
charge
differentials
justified
ground
blues
pay
hospitals
promptly
efficiently
importantly
provide
coverage
many
subscribers
commercial
insurers
reject
unacceptable
risks
blues
practice
called
open
enrollment
consistently
cited
principal
reason
charge
differentials
whether
differentials
resulted
voluntary
negotiation
hospitals
payers
case
prior
nyphrm
system
created
surcharges
case
see
charge
differential
analysis
committee
new
york
state
hospital
review
planning
council
report
reprinted
joint
appendix
pp
corcoran
superintendent
insurance
update
position
paper
new
york
state
insurance
department
inpatient
reimbursement
rate
differential
provided
insurers
trussell
prepayment
hospital
care
new
york
state
trussell
thorpe
rate
setting
work
case
new
york
prospective
hospital
reimbursement
methodology
health
politics
policy
law
since
surcharges
presumably
passed
least
part
purchase
commercial
insurance
hmo
membership
effects
follow
purpose
although
evidence
surcharges
drive
every
health
insurance
consumer
blues
make
blues
attractive
less
unattractive
insurance
alternatives
thus
indirect
economic
effect
choices
made
insurance
buyers
including
erisa
plans
new
york
state
blue
cross
plans
travelers
indirect
economic
influence
however
bind
plan
administrators
particular
choice
thus
function
regulation
erisa
plan
commercial
insurers
hmos
may
still
offer
attractive
packages
blues
indirect
influence
surcharges
preclude
uniform
administrative
practice
provision
uniform
interstate
benefit
package
plan
wishes
provide
one
simply
bears
costs
benefits
relative
costs
competing
insurance
provide
influence
affect
plan
shopping
decisions
affect
fact
plan
shop
best
deal
get
surcharges
surcharges
indeed
nothing
remarkable
surcharges
hospital
bills
effects
overall
cost
plans
relative
attractiveness
certain
insurers
rate
variations
among
hospital
providers
accepted
examples
cost
variation
since
hospitals
traditionally
attempted
compensate
financial
shortfalls
adjusting
price
schedules
patients
commercial
health
insurance
thorpe
supra
charge
differentials
commercial
insurers
even
prior
state
regulation
varied
dramatically
across
regions
ranging
percent
presumably
reflecting
geographically
disparate
burdens
providing
uninsured
see
see
also
trussell
bobinski
unhealthy
federalism
barriers
increasing
health
care
access
uninsured
davis
rev
common
character
rate
differentials
even
absence
state
action
renders
unlikely
erisa
meant
bar
new
york
state
blue
cross
plans
travelers
indirect
economic
influences
state
law
existence
common
state
action
indirect
economic
effects
plan
costs
leaves
intent
even
less
likely
quality
standards
example
set
state
one
subject
area
hospital
services
another
affect
relative
cost
providing
services
others
providing
different
packages
health
insurance
benefits
even
basic
regulation
employment
conditions
invariably
affect
cost
price
services
quality
control
workplace
regulation
sure
presumably
less
likely
affect
premium
differentials
among
competing
insurers
change
fact
state
regulation
indirectly
affect
erisa
plan
afford
get
money
thus
absence
exact
guide
intended
fair
conclude
mandates
rate
differentials
unless
regulation
indirect
effects
plan
costs
superseded
well
bigger
package
regulation
indirect
effects
fall
respondent
reading
less
likely
federal
regulation
benefit
plans
intended
eliminate
state
regulation
health
care
costs
indeed
read
provision
displacing
state
laws
affecting
costs
charges
theory
indirectly
relate
erisa
plans
purchase
insurance
policies
hmo
memberships
cover
services
effectively
read
limiting
language
statute
conclusion
violate
basic
principles
statutory
interpretation
squared
prior
pronouncement
reemption
occur
state
law
tenuous
remote
peripheral
connection
covered
plans
case
many
laws
general
applicability
district
columbia
greater
washington
board
trade
slip
internal
quotation
marks
citations
omitted
congress
extension
state
laws
relating
benefit
plans
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