Courts divided on AWP laws

Article Abstract:

Some courts believe state any-willing-provider laws should be pre-empted by the federal Employee Retirement Income Security Act (ERISA) and some courts do not. Any-willing-provider laws prevent health insurers from discriminating against any provider in its geographic area who is willing to participate in the plan.

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High court rules ERISA pre-empts negligence claims against HMOs

Article Abstract:

The U.S. Supreme Court has reversed the decision of the U.S. Court of Appeals for the Fifth Circuit, holding that the Employee Retirement Income and Security Act (ERISA) has pre-empted the plaintiffs' negligence claims against the health maintenance organizations (HMOs). The patients would be required to file a law-suit under ERISA to cover the cost of benefits purportedly denied them, but would not be able to obtain compensatory damages for injuries sustained.

United States, Legal issues & crime, Government regulation (cont), Government regulation, Legal/Government Regulation, Health Maintenance Organizations, HMO Medical Centers, Hospital and medical service plans, Negligence, Powers and duties, United States. Supreme Court

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ERISA update

Article Abstract:

A US district court judge in Texas has upheld a patient's right to sue a health maintenance organization (HMO) for injuries resulting from medical malpractice. The Employee Retirement Income Security Act (ERISA) imposes federal regulations on employee benefit plans, superseding state laws regarding some benefits. ERISA was thought to insulate HMOs from malpractice claims. The Texas judge held that HMOs remain subject to claims arising from poor-quality medical care, but not claims related to benefit determination as covered by ERISA.

Malpractice, Patients

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