Out-of-network Healthcare providers' RICO Claims for payment problems were recently "reverse preempted" pursuant to the McCarran-Ferguson Act (which reserves the regulation of Insurance to the States) "by Ohio laws regulating the business of insurance." This was the narrow holding in this regard in Download Riverview Health Institute LLC v. Medical Mutual of Ohio (6th Cir. Case No. 08.4431, Opinion Filed April 7, 2010), also published as Riverview Health Institute LLC v. Medical Mutual of Ohio, 601 F.3d 505, 511 (6th Cir. 2010)(Westlaw subscription required to access Westlaw). With no tongue visibly in cheek, the Sixth Circuit defined "reverse preemption" as a kind of "inverse preemption": "'Reverse preemption' is a form of inverse preemption that prevents a generally applicable federal law from inadvertently invalidating, impairing, or superseding state laws enacted to regulate the business of insurance." Id. at 511 n.1.
The Defendants which were thereby immunized by the holding to that extent, were a Health Insurance Company and its Officers. The out-of-network providers also alleged Claims in their Complaint under ERISA itself, Fraud, Breach of Contract, and Tortious Interference With Business Relationships.
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