Managed care liability and ERISA preemption.
Patients enrolled in managed care organizations (MCOs) are concerned about quality of care and restrictions imposed. There is concern about being harmed due to the negligence of MCOs. Meanwhile, MCOs are protected by the federal Employment Retirement Income Security Act (ERISA) of 1974, which preempts state law claims and results in eliminating many of the recoveries otherwise available to a harmed beneficiary in non-MCOs. This article reviews the ERISA exemption and legal theories for patient redress.
Rakich
J S
JS
School of Business and Economics, Indiana University Southeast, New Albany, USA.
Ledbetter
R K
RK
D019461:Employee Retirement Income Security Act; D016365:Liability, Legal; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008329:Managed Care Programs / Q000331:legislation & jurisprudence* / Q000592:standards; D020380:Needs Assessment / Q000331:legislation & jurisprudence; D014481:United States; D014600:Utilization Review / Q000331:legislation & jurisprudence