Litigating around ERISA to quality managed healthcare: an HMO can breach fiduciary duties.
نویسنده
چکیده
منابع مشابه
Dividing loyalties: caring for individuals and populations.
Are health maintenance organization (HMO) physicians obligated to act exclusively in the interest of the individual patient? Does the mere existence of financial incentives to limit patient care violate this obligation? To what extent are doctors responsible for the population of patients served by a health plan, or for promoting a fair distribution of health care among society as a whole? Thes...
متن کاملPegram's significance for managed health care.
On June 12, 2000, in a unanimous opinion written by Justice Souter, the U.S. Supreme Court, reversing a decision of the U.S. Court of Appeals for the Seventh Circuit, held in Pegram v. Herdrich that “mixed eligibility” decisions made by HMO physicians are not fiduciary decisions under ERISA. In so ruling, the Court upheld the concept that the reasonable sharing of financial risk with HMO networ...
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Stephen D. Rosenberg, Esq. is a partner in the McCormack Firm, a Boston litigation firm, where he heads the firm’s ERISA Practice Group. He has extensive experience in ERISA litigation, including breach of fiduciary duty cases and class actions, as well as in commercial litigation and arbitration, insurance coverage and bad faith, and intellectual property disputes. He publishes a blog at www.b...
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Since 1977, the popularity of the limited liability company (“LLC”) has grown tremendously, overtaking the corporation and the partnership as the preferred business structure in many jurisdictions. Amidst this growth in popularity, a legal debate has sparked concerning the existence, nature, and extent of the fiduciary and contractual duties owed in the LLC context. Drafters of LLC agreements c...
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ion, the difference between the two perspectives can seem to fade into insignificance. On the one hand, fiduciary law is perfectly capable of accommodating nonmandatory obligations. Fiduciary law scholars readily acknowledge that, under certain circumstances, shareholders should be permitted to waive at least some fiduciary duties. 141 Generally, they simply want to put in place sufficient safe...
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عنوان ژورنال:
- Specialty law digest. Health care law
دوره 263 شماره
صفحات -
تاریخ انتشار 2001