HMO liability laws may hit roadblocks; N.Y. and Texas initiatives may be stymied by ERISA
Article Abstract:
Health maintenance organizations (HMOs) have always been able to evade malpractice liability due to federal court rulings that ERISA preempted any state law regulating the health benefits funded by employer-sponsored plans. That may change in New York state, which in 1997 will enact a law giving HMOs malpractice liability, holding that they must follow a "reasonable care" standard with decisions to delay treatment or deny payment. Texas in May 1997 became the first state allowing suits against HMOs for injuries caused by refusals to pay for treatment. Other states' ways around the ERISA defense are covered.
Publication Name: The National Law Journal
Subject: Law
ISSN: 0162-7325
Year: 1997
User Contributions:
Comment about this article or add new information about this topic:
New danger for HMOs; court says federal law doesn't always pre-empt, and HMOs can be sued
Article Abstract:
Recent rulings by US circuit courts offer a way to sue health maintenance organizations in state courts despite the protection of the federal Employee Retirement Income Security Act. The HMOs have long used ERISA to bar most state actions regarding erroneous withholding of benefits, but in two cases against US Healthcare the 3d Circuit decided that causes of action attacking the quality of care are a matter for state courts. Plaintiffs' lawyers hope to use the common-law theories of ostensible agency and breach of contract.
Publication Name: The National Law Journal
Subject: Law
ISSN: 0162-7325
Year: 1996
User Contributions:
Comment about this article or add new information about this topic:
Suits against managed care providers may elude ERISA; with increasing success, malpractice and quality-of-care claims against HMOs are circumventing ERISA's broad pre-emption
Article Abstract:
Direct-liability claims, negligent selection and supervision or negligent plan-design claims and vicarious-liability claims are the three general categories of claims which continue to be filed against managed care organizations despite the pre-emption provisions of ERISA. It may, in the last analysis, be Congress which formulates a definitive response to quality-of-care matters.
Publication Name: The National Law Journal
Subject: Law
ISSN: 0162-7325
Year: 1998
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Asian-Americans find place in the profession; Pacific Rim and tech booms create major firms' biggest minority
- Abstracts: How to succeed in a (still) masculine world; the main thing is to go in with no illusions and play the game hard - their way
- Abstracts: How individual trustees can avoid liability and breaches of trust. Recent regulations clarify use of QSSTs in estate planning
- Abstracts: Investors' appeal: Securities Act bans indemnity contract. AG: death-penalty counsel says it with cookies; Calif. agency is accused of using gifts to persuade an inmate to fight sentence
- Abstracts: ABCs of upgrading PCs; when it's time for an overhaul, price should take a backseat to functional needs. Playing the name game; choose an e-mail address that is descriptive and easily remembered