Summary
The Nebraska Supreme Court held that Neb. Rev. Stat. § 44-513 does not prohibit health insurance policies from imposing different copayments for covered services provided by different types of licensed providers. The court affirmed the district court’s dismissal of a declaratory judgment action brought by policyholders seeking copayment parity for chiropractic and medical services.
Topics
Practice areas
Questions Presented
- Whether Neb. Rev. Stat. § 44-513 requires health insurance policies to impose identical copayments for a covered service regardless of whether the service is provided by a chiropractor or a medical doctor.
- Whether the statute's language is sufficiently ambiguous to warrant resort to legislative history.
Holdings
- Neb. Rev. Stat. § 44-513 does not prohibit an insurer from requiring different copayments for different types of providers. The statute requires coverage or reimbursement for a covered service when performed by an authorized listed provider, but it does not require the policyholder's copayment to be identical regardless of provider type.
- Because the plain language of § 44-513 is clear and does not require copayment parity, resort to legislative history is unnecessary.
- An appellate court will not read into a statute a meaning that is not there.
Key quotations
“The plain language of § 44-513 does not prohibit an insurer from requiring different copayments for different types of providers.” (299 Neb. at 135)
Factual background
Nebraska health insurance policies permitted insurers to charge policyholders higher copayments for covered services obtained from chiropractors than for the same services obtained from medical doctors, even when both providers were in-network and legally authorized to perform the service. Three Nebraska residents and a nonprofit corporation challenged that practice, arguing that Neb. Rev. Stat. § 44-513 required equal copayments for the covered service regardless of provider type.
Procedural history
The policyholders sued the director of the Nebraska Department of Insurance seeking a declaration that Neb. Rev. Stat. § 44-513 prohibited insurance policies from imposing a higher copayment when a covered service was obtained from a chiropractor rather than a medical doctor. The district court concluded that the statute did not require equal copayments, overruled the policyholders' summary judgment motion, and dismissed the complaint. The Nebraska Supreme Court accepted the appeal for bypass review and affirmed.