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Managed care, liability, and ERISA.

A A Stone1

  • 1Department of Law, Harvard University Law School, Cambridge, Massachusetts, USA.

The Psychiatric Clinics of North America
|March 20, 1999
PubMed
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The Employee Retirement Income Security Act (ERISA) was not intended to shield health plans from malpractice claims. Recent court rulings suggest ERISA may not fully protect against liability, potentially restoring accountability for medical care standards.

Area of Science:

  • Healthcare Law
  • Medical Malpractice
  • Employee Benefits Law

Background:

  • The Employee Retirement Income Security Act (ERISA) was enacted in 1974 to protect employee benefits.
  • ERISA's preemption clause has been interpreted to shield certain health plans from liability, including malpractice claims.
  • This protection has raised concerns about reduced professional standards of care and lack of accountability.

Purpose of the Study:

  • To analyze the original intent of ERISA regarding employer-sponsored health plans and malpractice.
  • To examine how ERISA preemption has impacted medical malpractice litigation and healthcare standards.
  • To discuss recent legal challenges and their implications for ERISA's liability shield.

Main Methods:

  • Legal analysis of ERISA's legislative history and intent.

Related Experiment Videos

  • Review of key court cases, including Dukes and Corcoran, interpreting ERISA preemption.
  • Examination of Department of Labor perspectives on ERISA and malpractice claims.

    • Main Results:

    • ERISA's original purpose was to secure employee benefits, not to eliminate malpractice liability for health plans.
    • Judicial interpretations have created loopholes ('chinks in the legal armor') in ERISA's preemption, allowing some damage claims.
    • There is growing recognition, even among conservative judges, of the potential injustice resulting from broad ERISA preemption in malpractice cases.

    Conclusions:

    • ERISA preemption's application to medical malpractice claims may be narrower than previously assumed.
    • Recent judicial decisions indicate a potential shift towards holding health plans accountable for substandard care.
    • Malpractice liability, traditionally viewed negatively by the medical profession, might serve a beneficial purpose in ensuring quality of care under ERISA.