Document Type
Article
Publication Date
8-24-2000
ISSN
0028-4793
Publisher
Massachusetts Medical Society
Language
en-US
Abstract
Should managed-care organizations be accountable to patients injured by the company's negligence or wrongdoing? The general rule is that all organizations, including managed-care organizations, are legally liable for causing personal injury as a result of their own negligence or the negligence of their employees or agents.1-4 However, as most observers of the U.S. health care system know by now, there is an exception to this basic legal rule of accountability. The Employee Retirement Income Security Act of 1974 (ERISA) has been interpreted to grant health benefit plans provided by employers or unions (and the managed-care organizations that sell or administer them) immunity from ordinary tort liability for their own negligence with respect to members of the plan.5,6 Whether to end that immunity is the chief point of contention in the debate in Congress about a patients' bill of rights.
The U.S. Supreme Court, in the case of Pegram v. Herdrich, gave the managed-care industry protection from one form of liability, but the June 2000 decision may intensify public demand for an end to immunity under ERISA.7
Recommended Citation
Wendy K. Mariner,
What Recourse?—Liability for Managed Care Decisions and the Employee Retirement Income Security Act
,
in
343
New England Journal of Medicine
592
(2000).
Available at:
https://doi.org/https://doi.org/10.1056/NEJM200008243430823
Comments
From The New England Journal of Medicine, Wendy K. Mariner, What Recourse?—Liability for Managed Care Decisions and the Employee Retirement Income Security Act, Volume 343, Page 592, Copyright © 2000 Massachusetts Medical Society. Reprinted with permission.