Massachusetts Medical Society
This article summarizes and critiques the U.S. Supreme Court's decision in Aetna Health Inc. v. Davila, which limited managed care organizations' liability for negligent decisions about the care of patients in private employer-sponsored health plans governed by ERISA. It contrasts the Court's dichotomous view of health benefit plans, in which insurers administer contracts and treating physicians make medical judgments, with the more complicated relationships that affect decisions about both coverage and treatment.
Wendy K. Mariner,
The Supreme Court's Limitation of Managed-Care Liability,
The New England Journal of Medicine
Available at: https://scholarship.law.bu.edu/faculty_scholarship/357