# Amicus Curiae Brief — Rebaldo v. Cuomo

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URL: https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385017_2442%3A4

## Record

- **Collection:** Supreme Court brief
- **Document type:** Amicus Curiae Brief
- **Published:** January 1, 1985
- **Citation:** 472 U.S. 1008

## Text

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No. 84-1347 ~ a. Supreme Court. US
eS 8),

IN THE

Supreme Court of the United State

APR 23 1985

CLERK

ALEXANDER UL. STEVAS

os ane

OCTOBER TERM, 1984

SEBASTIAN REBALDO, AS CHAIRPERSON OF THE BOARD OF
TRUSTEES OF THE UNITED OPTICAL WORKERS INSURANCE FUND,
Petitioner,

VS.

Mario CuoMo, GOVERNOR OF THE STATE OF NEW YORK; and
DAvID AXELROD, COMMISSIONER OF HEALTH OF THE
STATE OF NEW YORK,

Respondents.

On Petition for a Writ of Certiorari to the
United States Court of Appeals for the Second Circuit

BRIEF OF AMICUS CURIAE BLUE CROSS AND
BLUE SHIELD OF GREATER NEW YORK

ROBERT A. BICKS

BREED, ABBOTT & MORGAN
153 East 53rd Street
New York, New York 10022
(212) 888-0800

Counsel of Record for Blue Cross
and Blue Shield of Greater New
York

Or COUNSEL:

ROBERT A. BICKS

ALAN C. DREWSEN

MICHIKO TAMATE

BREED, ABBOTT & MORGAN
153 East 53rd Street
New York, New York 10022
(212) 888-0800

BEST AVAILABLE COPY

TABLE OF CONTENTS

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A. The Purpose of NYPHRM......................0........
B. The Operation of NYPHRM.............................

C. The Role of Blue Cross In New York’s Health
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THE DECISION BELOW IS CONSISTENT WITH DECI-
SIONS OF THIS COURT AND DOES NOT CONFLICT
WITH DECISIONS OF OTHER CIRCUITS. ..................--

A. The Decision Below Squares With Prior Deci-

“ge” EES cepa mary re

B. The Decision Below Accords with Applicable
Decisions From Other Circuits .....................

C. Without Record Basis Are Petitioner’s Claims

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I itiinicsemcinaiviciticinatnicen PR NF Oe RE SO ae

STIPULATION OF CONSENT FOR BLUE CROSS TO APPEAR
LES LE ET IRM OR IO SAE

ii
TABLE OF AUTHORITIES

CASES
Alessi v. Raybestos-Manhattan, Inc., 451 U.S. 504
(EET SS Soe eee ee a

Buczynski v. General Motors Corp., 616 F.2d 1238 (3d
Cir. 1980), aff'd sub nom. Alessi v. Raybestos-
Manhattan, Inc., 451 U.S. 504 (1981) ...................

Hewlett-Packard Co. v. Barnes, 571 F.2d 502 ( 9th Cir. ),
cert. denied, 439 U.S. 831 (1978) ...........ccccccceeeeeeeeeeeees

Hewlett-Packard Co. v. Barnes, 425 F.Supp. 1294
(N.D. Ca. 1977), aff'd, 571 F.2d 502 (9th Cir. ), cert.
I I Ets EE © BET) nccscecncccrsesccssccccssssvecesercesece

Metropolitan Life Insurance Co. v. Massachusetts, No.
84-325, argument scheduled. ....................c0cccceeesseeeeeeevees

Rebaldo v. Cuomo, 749 F.2d 133 (2d Cir. 1984) .............
Shaw v. Delta Air Lines, Inc., 103 S. Ct. 2890 (1983).....

Standard Oil Co. v. Agsalud, 633 F.2d 760 (9th Cir.
1980), aff'd mem., 454 U.S. 801 (1981)...

STATUTES AND REGULATIONS

29 U.S.C. § 1001 et seq. (1982) (Employee Retirement
Income Security Act of 1974 (“ERISA”) ) ...................

Section 3( 1), 29 U.S.C. § 1002 (1) ......ccccccccsscccccccees
Section 3( 32), 29 U.S.C. § 1002 (32) 0.0.0...
Section 4(b)(1), 29 U.S.C. § 1003 (b) ........ ee.
Section 514(a), 29 U.S.C. § 1144 (a)...
Section 514(b), 29 U.S.C. § 1144 (b) ......
Section 514(c), 29 U.S.C. § 1144 (c) .......
G2 UBC. © Been Oe FCC) CIDER ) .........cccccccccccccccces
N.Y. Ins. Law § 4308 (McKinney 1984) .........................

N.Y. Pub. Health Law § 2807-a et seq. (McKinney
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N.Y. Pub. Health Law § 2807-a(6)(b) (McKinney
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12
7, 8, 9, 11, 12
8, 9, 10

No. 84-1347

IN THE

Supreme Court of the United States

OcTOBER TERM, 1984

SEBASTIAN REBALDO, as CHAIRPERSON OF THE BOARD OF
TRUSTEES OF THE UNITED OpTICAL WORKERS INSURANCE FUND,
Petitioner,

VS.

Mario CuoMo, GOVERNOR OF THE STATE OF NEW YORK; and
Davipd AXELROD, COMMISSIONER OF HEALTH OF THE
STATE OF NEW YORK,

Respondents.

On Petition for a Writ of Certiorari to the
United States Court of Appeals for the Second Circuit

BRIEF OF AMICUS CURIAE BLUE CROSS
AND BLUE SHIELD OF GREATER NEW YORK

INTEREST OF THE AMICUS CURIAE

Blue Cross and Blue Shield of Greater New York (“Blue
Cross”), with the consent of all parties, submits this amicus
curiae brief in opposition to the petition for certiorari. The
decision below correctly construed ERISA’ to avoid conflict

1The Employee Retirement Income Security Act of 1974, 29
U.S.C. § 1001 et seg. (1982) (“ERISA”).

2

with long-standing New York State policy to promote max-
imum availability of health insurance coverage at affordable
rates.

A. The Purpose of NYPHRM

This proceeding seeks to preempt under ERISA one key
provision of New York State’s Prospective Hospital Reimburse-
ment Method, N.Y. Pub. Health Law §2807-a ef seg.
(McKinney Supp. 1984) (“NYPHRM”), enacted in 1982.
NYPHRM is a three year experiment in the comprehensive
regulation of all financing for hospital inpatient services, which
by its terms ends on December 31, 1985.2 Adopting NYPHRM,
the State’s goal was to curb an unacceptable rate of inflation in
the cost of hospital care, and at the same time to ameliorate
operating deficits plaguing certain not-for-profit hospitals as
well as distribute more equitably the burden of funding hospital
services.

NYPHR\M, for the first time, empowers the State to control
all aspects of hospital care financing by regulating all sources of
hospital revenue—particularly, the prices at which all persons
may purchase hospital services. Before NYPHRM, the State
controlled reimbursement to hospitals by the State Medicaid
Program and by not-for-profit insurers such as Blue Cross.
Also, pre-NYPHRM, the State regulated the charges that
hospitals levied upon others. However, the State had no power
over the largest single purchaser of hospita! services, the federal
Medicare Program. The upshot was that while the State had

2Since NYPHRM runs out at year’s end, now under consid-
eration is whether to extend NYPHRM,, as is or in some altered form,
as well as alternative modes for financing hospital services in New
York. On such issues, all interested parties have had their say,
including State officials, legislators, commercial carriers, the State's
Blue Cross plans, representatives of self-insured funds and other
persons. If NYPHRM is allowed to expire and the financing of
hospital inpatient services is determined pursuant to a new statute or
returned to the methodology that NYPHRM replaced, this case will
be moot. Likewise, if NYPHRM is to be extended, self-insured funds
are urging the very change in NYPHRM that petitioner seeks to bring
about through ERISA preemption. Such an amendmen: would also
render the case moot.

3

long since decreed that Medicaid and Blue Cross reimburse
hospitals at prospectively determined rates that accounted only
for efficient performance of services, Medicare operated under
no such discipline. Since the State had “no role in setting
Medicare rates or handling Medicare payments . . . Medicare
continued until 1982 to calculate hospital entitlements on the
basis of costs computed at the end of each fiscal year.” (App.
4.)3 Because NYPHRM would not work unless Medicare
reimbursement was brought under effective State regulation,
the Legislature specified that NYPHRM could not take effect
until the federal government agreed to adopt NYPHRM’s
methodology for Medicare reimbursement. 1982 N.Y. Laws
$36 § 10(a).

New York thus applied for a Medicare “waiver,” ie.,
authorization from the federal government to adopt NYPHRM
as an experiment in Medicare reimbursement that was other
than cost-based.4 This waiver the federal government granted
in December of 1982, and the State promptly proceeded to
implement NYPHRM.

B. The Operation of NYPHRM

NYPHRM requires that the State “establish for each
hospital an ‘inpatient revenue cap’, i.e., the maximum amount
of inpatient revenue the hospitai will be authorized to receive
for services during a twelve-month period .. . .” (App. 7.)
Each “general hospital is [then] required to establish a charge
schedule sufficient to generate the inpatient revenue authorized
by the revenue cap” (id.), taking into account that the Legisla-
ture had determined that certain payors were to receive a
“differential” from the hospitals’ gross charges. See
§ 2807-a(6)(b). At the same time, the Legislature concluded

3 References are to the Appendix to the Petition.

“From the outset of Medicare, Congress had empowered the
Secretary of Health, Education and Welfare to engage in “ex-
periments and demonstration projects” to determine, inter alia,
“whether the rates of payment or reimbursement for health care
services, approved by a State . . . would have the effect of reducing
the costs of such programs [| Medicare] without adversely affecting the
quality of such services.” 42 U S.C. § 139Sb-1(a)(1)(C) (1982).

a

that all other payors, government-sponsored as well as private,
were to pay the hospitals’ established charges.

Thus, NYPHRM prescribes two levels of payment for
hospital inpatient services. The first is based on each hospital's
applies to the federal Medicare program, the State's Medicaid
program, corporations under Article 43 of the Insurance Law,
which includes the State's Blue Cross Plans, and health mainte-
nance organizations throughout New York. All other payors,
such as commercial carriers, the State's Workers Compensation
program, its no-fault insurance program, uninsured persons,
and self-insurers such as the petitioner, pay the hospital's
charges, which are set by statute at no more than 12-15% above
such “costs.” NYPHRM does not distinguish among charge-
payors except to permit hospitals to continue any “negotiated
payment rate determination systems [with] self-insured and
self-administered groups” that were already in effect on May |,
1982.

Cc. The Role Of Blue Cross In New York's Health Care

Delivery System

Blue Cross is a not-for-profit health services corporation
organized and operating for almost one-half century now
pursuant to Article 43 ( formerly Article [X-C ) of the New York
State Insurance Law. Blue Cross operates in a 1 7-county area
that includes New York City and its environs. It provides
hospital and health related benefits to some 9 million persons.
An additional 4 million persons are covered by other Blue Cross

plans that operate, also pursuant to Article 43, throughout the
State.

New York State's Superintendent of Insurance and Com-
missioner of Health closely regulate all aspects of Blue Cross's
operations. Thus, Blue Cross can offer no contract to sub-
scribers without the prior approval of the Superintendent. N_Y.
ins. Law § 4308 (McKinney 1984). Similarly, Blue Cross rates
or “premiums” to its subscribers must also be approved by the
Superintendent. (/d.) Blue Cross can reimburse hospitals and

5

other institutional providers of care to subscribers only in
by the Commissioner of Health under NYPHRM.

Since its founding in the 1930's, Blue Cross has been
regulated by the State in such a manner as to further various
community ends the State has deemed worthy. Included

among these ends are the following:

First, via its “open enrollment” periods, during which
any person regardless of prior illness, physical condition,
age or sex can obtain health insurance, and its Medicare
supplementary coverage, Blue Cross—unlike commercial
carriers—affords coverage at a uniform community-wide
rate otherwise unavailable for high-risk individuals.
Community-rated and Medicare supplementary coverage
resulted in an operating loss for Blue Cross of
$116,000,000 for the three year period ended December
31, 1982;

Second, w provide hospitals needed operating funds,
Blue Cross, but no charge-payor under NYPHRM, makes
various interim payments to hospitals and otherwise pro-
vides their working capital prior to formal submission of
claims. During 1983 the average outstanding balance in
the advanced financing program was $180,400,000 which
reduced Blue Cross’s investment income by almost

Third, Blue Cross provides comprehensive coverage
which, in turn, limits the amount of bad debts incurred by
hospitals, bad debts which ran roughly $260,000,000 in
1982, the year before NYPHRM went into effect.

Recognizing the cost of such public functions as well as the
fact that NYPHRM both decreased Blue Cross’s pre-
NYPHRM “differential” and otherwise increased Blue Cross's
annual costs another $100,000,000 by requiring contribution to
a hospital bad debt and charity pool, the Legislature deter-

6

mined that Blue Cross (along with Medicare and Medicaid)
should purchase hospital services on a basis different from other
payors.5 Invalidation of § 2807-a(6)(b), as petitioner here
seeks, would undermine this difference in treatment and leave
one category of payors, self-insured benefit plans, free from any
State regulation over the price at which they may negotiate for
hospital services. Such consequence would disparage Blue
Cross’s ability to perform those community functions with
which it has been charged.

Blue Cross, to repeat, is required to insure, on a
“community-rated” basis, persons and groups that are, on the
whole, older, poorer and less healthy than “experience-rated”
groups and therefore constitute unacceptably high risks for
other insurers. To insure all persons at a uniform and
affordable “community” rate, Blue Cross relies on a subsidy
which it collects from its “expericnce-rated” groups. Without a
hospital payment differential, premiums to such groups could
not be set at a level that would provide the necessary subsidy,
without losing them to competitors who accept no such public
responsibility. Typically, ““experience-rated” groups are com-
prised of members who are employed, on the whole younger,
and generally healthier than those who pay the community
rate. Covering such “experience-rated” groups, Blue Cross
includes a 1% subsidy for community rates in its retention
formula used in calculating rates. Beyond that, all investment
income earned on premiums paid by “experience-rated” groups
goes to subsidize the community rate.

In short, for Blue Cross to continue to offer adequate
protection to those whose needs are the greatest, it must depend
upon, and also be attractive to, those groups whose needs are
less. However, it is those ““experience-rated” groups with lesser
needs that, afforded a unique freedom from regulation and the
right to negotiate hospital rates, would be most likely to move

5 As the district court concluded, “defendants and amicus have
provided the Court with considerable justification for the payment
rate differential established between ERISA plans and corporations
such as Blue Cross.” (App. 27.)

7

away from Blue Cross, thereby eroding the very subscriber base
on which State policy has long banked in utilizing Blue Cross as
its instrument for affordable community rates.

STATEMENT OF THE CASE

Petitioner is Chairperson of a self-insured and self-
administered employee welfare benefit plan (the “Fund”’)
regulated by ERISA. The Fund had no contracts in place with
hospitals at the statutory cutoff date of May 1, 1982. As of the
date it became a self-insurer on January 1, 1983, the Fund
apparently entered into contracts with hospitals for inpatient
services at rates below those prescribed in § 2807-a(6)(b). In
December, 1983, almost one and one-half years after
NYPHRM was enacted, this suit was commenced to preserve
those contracts entered into after NYPHRM’s deadline.

The district court for the Southern District of New York
granted summary judgment for petitioner and declared § 2807-
a(6)(b) to be preempted by ERISA § 514(a) “to the extent it
prohibits a hospital from establishing inpatient charges for self-
insured employee benefit plans covered by ERISA which are
other than those authorized by Public Health Law § 2807-
a(6).” (App. 45.)

Vacating the decision of the district court, the United
States Court of Appeals for the Second Circuit held, in Rebaldo
v. Cuomo, 749 F.2d 133 (2d Cir. 1984), that § 2807-a(6)(b)
does not purport to regulate the structure, administration or
benefits afforded by ERISA plans. Therefore that statute was
deemed not to “relate to” ERISA plans and not preempted
under ERISA § 514(a).

SUMMARY OF ARGUMENT

Petitioner has failed to show that the decision below
conflicts with the decision of any other court of appeals or with
applicable decisions of this Court. As a result, the petition for
certiorari should be denied.

" 8

ARGUMENT
THE DECISION BELOW IS CONSISTENT
WITH DECISIONS OF THIS COURT AND DOES
NOT CONFLICT WITH DECISIONS OF OTHER
CIRCUITS

The beginning point below was that, reading ERISA
§§ 514(a) and 514(c)(2) together, “a state law must ‘pur-
port[ ] to regulate... the terms and conditions of employee
benefit plans’ to fall within the preemption provision” (App.
9). The court recognized the “broad and liberal construction”
given the term “relate to” by the Supreme Court in Shaw vy.
Delta Air Lines, Inc., 103 S. Ct. 2890 (1983) (App. 10) and
that “ERISA preempts state laws that require or forbid the
provision of a certain kind of benefit.” (App. 11.) At the same
time, the court went on to emphasize that:

ERISA does not invalidate those State statutes whose
effect on pension plans is simply tangential in nature. . . .
This conclusion follows as a matter of common sense from
the fact that ERISA plan members and managers are
bound to engage in myriad transactions that Congress
never considered when it drafted § 514. A preemption
provision designed to prevent state interference with feder-
al control of ERISA plans does not require the creation of
a fully insulated legal world that excludes these plans from
regulation of any purely local transaction. (App. 10.)

This conclusion applies with particular force where, as here, the
“containment of hospital costs is an exercise cf = State’s police
powers, which should not be superseded by federal regulations
unless that was the clear intent of Congress.” ( Jd.)

Against that background, the court held that ““New York’s
decision to regulate the amounts hospitals can charge” was
among those “state actions [that] may affect employee benefit
plans in too tenuous, remote, or peripheral a manner to warrant
a finding that the law ‘relates to’ the plan.” (App. 11.) Re ected
because it “proves altogether too much” was the contention

9

that NYPHRM should be preempted because it increased the
Fund’s cost of doing business:

The purchase of hospital service is like the purchase of
public utility service, or of any other service or commodity
whose price is controlled by the State. Insofar as the
regulation of hospital rates affects a plan’s cost of doing
business, it also may be analogized to State labor laws that
govern working conditions and labor costs, to rent control
laws that determine what employee benefit plans pay or
receive for rental property, and even to such minor costs as
the Thruway, bridge and tunnel tolls that are charged to
pians’ officers or employees. In short, if ERISA is held to
invalidate every State action that may increase the cost of
operating employee benefit plans, those plans will be
permitted a charmed existence that never was con-
templated by Congress. Where, as here, a State statute of
general application does not affect the structure, the admin-
istration, or the type of benefits provided by an ERISA
plan, the mere fact that the statute has some economic
impact on the plan does not require that the statute be
invalidated. (App. 12.)

Nor was whatever “indirect economic impact as may result
from State control over hospital rates” deemed to “run counter
to ERISA’s aim of national uniformity in plan regulation.”
(App. 12-13.) For even without NYPHRM, “every hospital
will be able to set its own rates for ERISA plans, and
[ petitioner] does not contend that these rates are, or will be,
uniform, even as between hospitals in the same locality. Lack
of uniformity is not a valid argument for preemption of New
York’s statute.” (App. 13.)

A. The Decision Below Squares With
Prior Decisions By This Court

In Shaw v. Delta Air Lines, Inc., 103 S. Ct. 2890 (1983),
for example, the Court held that subsections of two New York
statutes relating to discrimination on the basis of preg-
nancy—the Human Rights Law and the Disability Benefits

10

Law—“relate[d] to” ERISA plans, the former because it
required a specific structure in ‘such plans and the latter because
it required that the plans pay specific benefits. Jd. at 2900. As
noted by the court below, by way of contrast, NYPHRM
regulates neither the structure of nor benefits to be provided by
ERISA plans. - In addition, while the purpose of the laws in
Shaw was to regulate employment practices, which includes the
provision of employee benefits, the purpose of NYPHRM is
solely to regulate hospital costs and is in no way concerned with
the structure, administration or benefits package of ERISA
plans.

Similarly, unlike Alessi v. Raybestos-Manhattan, Inc., 451
U.S. 504 (1981), no conflict exists between NYPHRM and
federal law. In Alessi, the New Jersey Workers’ Compensation
Act, which prohibited the integration of pension benefits with
workers’ compensation awards, was deemed to be preempted
because Congress had deliberately permitted integration.
Hence, preemption was based on the narrow ground that there
existed a “direct clash between the state statute and the federal
policy to keep calculation of pension benefits a subject of either
labor-management negotiations or federal legislation.” Jd. at
526 n.22.6 In contrast, no federal policy can be derived from
ERISA or any other federal law, with respect to the price
payable by particular persons—ERISA plans or anyone else
—for hospital inpatient services.

Also misplaced is petitioner’s reliance on Alessi for the
proposition that NYPHRM is preempted because through its
regulation of hospital costs it “indirectly” regulates ERISA
plans. (Petition, at 15-16.) As the Third Circuit found in
Alessi, the “only purpose and effect of the [New Jersey] statute
is to set forth an additional statutory requirement for pension
plans.” Buczynski v. General Motors Corp., 616 F.2d 1238, 1250
(3d Cir. 1980), aff'd sub nom. Alessi v. Raybestos-Manhattan,
Inc., 451 U.S. 504 (1981) (emphasis in original). Thus, the

6 The Supreme Court in Shaw recognized that the Alessi decision
rested narrowly on “the state law’s frusiration of [ particular] Con-
gressional intent.” Shaw, 103 S. Ct. at 2900 n.15.

11

statute was “indirect” only in that the pension regulation was
embodied in a workers’ compensation law.

Here, New York State makes no attempt to “avoid[ j
through form the substance of the preemption provision.”
Alessi, 451 U.S. at 525. NYPHRM in form and in fact is a
hospital cost containment statute. Nowhere mentioned is
ERISA. It does refer to “negotiated payment rate determina-
tion systems between self-insured and _ self-administered
groups”—but only to preserve those already in effect when
NYPHRM was enacted. The fact is that the great bulk of
ERISA plans are not “self-insured and _ self-administered
groups,” and many of the most Significant “employee benefit
plans” are exempt from ERISA. See 29 U.S.C. §§ 1002(1),
1002( 32), 1003(b)(1).

B. The Decision Below Accords with Applicable Decisions
from Other Circuits.

Thus, Standard Oil Co. v. Agsalud, 633 F.2d 760 (9th Cir.
1980), aff'd mem., 454 U.S. 801 (1981), held that ERISA
preempted Hawaii’s Comprehensive Prepaid Health Care Act
which, unlike NYPHRM, “directly and expressly regulates
employers and the type of benefits they provide employees.”
633 F.2d at 766.7 The decision below acknowledged that
“ERISA preempts state laws that require or forbid the provi-
sion of a certain kind of benefit” (App. 11), but correctly
concluded that NYPHRM was not such a law.

There is likewise no conflict with Hewlett Packard Co. v
Barnes, 571 F.2d 502 (9th Cir.), cert. denied, 439 U.S. 831
(1978). The California Knox-Keene Health Care Service Plan
Act there preempted indisputably regulated ERISA plans. The
California Act regulated “health care service plans” which were
any plans providing health care services or insurance (including
self-insurance ) in return for a prepaid charge. As noted by the

7 In fact, the State itself in Agsalud argued that the Hawaii Act
did not “relate to” a: employee benefit plan because it “pertain[ed ]
principally to benefits rather than administration.” Jd. at 765.

12

district court, the Act directly regulated “‘such areas as funding,
disclosure, sales practices and quality of services.” Hewlett-
Packard Co. v. Barnes, 425 F. Supp. 1294, 1297 (N.D. Ca.
1977), aff'd, 571 F.2d 502 (9th Cir. ), cert. denied, 439 U.S. 831
(1978).8

C. Without Record Basis Are Petitioner’s Claims Of Adverse
Impact

Finally, the petitioner, as well as the amici, fall back on the
prediction of dire consequences for self-insurance if the decision
below is allowed to stand. Thus, petitioner asserts that § 2807-
a(6)(b) makes self-insurance unprofitable, that all previously
self-insured funds will be forced to return to Blue Cross and will
then be forced to accept state-mandated benefits they might
otherwise not want to provide for their members. To this point
the short answer offered below suffices:

Where, as here, a State statute of general application
does not affect the structure, the administration, or the type
of benefits provided by an ERISA plan, the mere fact that
the statute has some economic impact on the plan does not
require that the statute be invalidated. (App. 12.)

8 Similarly wide of the mark is the suggestion that the “issues
presented are related closely to those before the Court in Metropolitan
Life Insurance Company v. Massachusetts, No. 84-325, argument
scheduled.” (Petition at 1.) While both concern ERISA preemption,
at this juncture the issues presented to this Court are otherwise
dissimilar.

In Metropolitan, the question is whether a Massachusetts statute
that requires insurance companies to provide specified medical ben-
efits in all their contracts, presumably including those sold to ERISA
plans, is saved from preemption by ERISA § 514(b), the insurance
savings clause. In the present case, the Second Circuit determined
that NYPHRM was not preempted by ERISA because the state
statute did not “relate to” ERISA plans. Hence, even if this Court
determines that the Massachusetts statute in Metropolitan is pre-
empted, based on an interpret #1 of the scope of the insurance
savings clause urged by appellant ierein, such a decision would have
no effect on whether § 2807-a(6)(b), which regulates the price
hospitals can charge for inpatient services, “relates to” ERISA plans.

13

CONCLUSION

The petition for a writ of certiorari should be denied.

< Respectfully submitted,

BREED, ABBOTT & MORGAN
. 153 East 53rd Street
New York, New York 10022
(212) 888-0800

Counsel of Record for
Blue Cross and Blue Shield
of Greater New York

OF COUNSEL:

ROBERT A. BICKS
ALAN C. DREWSEN
MICHIKO TAMATE

APPENDIX

SUPREME COURT OF THE UNITED STATES
Octoser Term, 1984

SEBASTIAN REBALDO, as Chairperson of the
Board of Trustees of the Unrrep Optica.
Workers INSURANCE FUND,

Petitioner,
— against —

Mario Cuomo, GOVERNOR OF THE STATE OF
New York; and Davip AxeL_rop, Commis-
SIONEK OF HEALTH OF THE STATE OF NEW

York,
Respondents.

It ts HEREBY AGREED by and between the parties herein,
through their counsel, that consent is given, pursuant to Rule 36
of the Revised Rules of this Court, for Blue Cross and Blue
Shield of Greater New York to file a brief in this proceeding
before the Supreme Court of the United States as amicus
curiae.

Dated: New York, New York
March 6, 1985

Sipser, Weinstock, Harper, Dorn
& Lemowrrz

By /s/
A Member of the Firm
Attorneys for Petitioner
380 Madison Avenue
New York, New York 10017
(212) 867-2100

ROBERT ABRAMS
Attorney General of the
State of New York

By /s/
Judith A. Gordon,
Assistant Attorney General
Attorney for Respondents
2 World Trade Center
New York, New York 10047
(212) 488-2462

---

Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385017_2442%3A4. Public record. Not legal advice.
