HMO malpractice: have the floodgates opened?
The U.S. Supreme Court's holding in Pegram v. Herdrich--that decisions by an HMO's physician employees in which eligibility issues and reasonable medical treatment are inextricably mixed are not fiduciary acts under the Employee Retirement Income Security Act (ERISA)--was applauded by the managed care industry. By delineating issues on which it was not ruling, however, the Court's decision may have given a boost to additional lawsuits against managed care plans on both ERISA and malpractice grounds.
Hansen
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Managed Liability Associates, Washington, DC, USA.
D019461:Employee Retirement Income Security Act / Q000331:legislation & jurisprudence; D015276:Health Care Rationing / Q000331:legislation & jurisprudence; D006279:Health Maintenance Organizations / Q000331:legislation & jurisprudence*; D006801:Humans; D008318:Malpractice / Q000331:legislation & jurisprudence*; D012052:Reimbursement, Incentive / Q000331:legislation & jurisprudence; D014481:United States