Corporate Health Insur., Inc. v. Texas Department Of Insurance, 215 F.3d 526 (5^th Cir. 2000)-The court considered insurance companies' ERISA preemption challenge to Texas's Senate Bill 386, which sought to regulate HMO's.  It concluded that ERISA did not pre-empt the bulk of the bill (the liability provisions and the anti-retaliation and anti-indemnification provisions) while ERISA did pre-empt the independent review provisions.

The bill's liability provisions extended an ordinary care standard for treatment decisions onto managed care entities. This court found that regulating quality of care is within the regulatory power of the State of Texas. "Although state efforts to regulate an entity in its capacity as plan administrator are preempted, managed care providers operate in a traditional sphere of state regulation when they wear their hats as medical care providers."

The anti-retaliation provision forbids a managed care entity from dropping or refusing to renew a doctor or health care provider for advocating medically necessary treatment, while the anti-indemnification provision prohibits a managed care entity from inserting a clause into contracts that would hold it harmless for its own acts. This court observed that these rules did not compel the entities to provide any substantive level of coverage as health care insurers, and denied that they mandated the structure and administration of plans.

As for the independent review provisions, this court observed that although they might avoid preemption under the ERISA's savings clause for laws regulating insurance, 29 U.S.C. § 1144(b)(2)(A), they fail the preemption test insofar as they attempt to create an alternative remedy for obtaining benefits under an ERISA plan. Although the independent review provisions do not create a cause of action for the denial of benefits, they do, however, "establish a quasi-administrative procedure for the review of such denial and bind the ERISA plan to the decision of the independent review organization."