Dealing with Self-Funded ERISA Payers in Managed Care: Employee Retirement Income Security Act (ERISA) of 1974

2009 ◽  
pp. 42-57
Keyword(s):  
Managed Care ◽  
Retirement Income ◽  
Income Security ◽  
Retirement Income Security

ERISA and RICO: New Tools for HMO Litigators

2000 ◽  
Vol 28 (1) ◽  
pp. 83-85
Author(s):  
Elaine T. Moore
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Financial Incentives ◽  
Labor Standards ◽  
Retirement Income ◽  
Fiduciary Duties ◽  
Income Security ◽  
Managed Care Organizations ◽  
Retirement Income Security

As the shield preempting state suits under the Employee Retirement Income Security Act (ERISA) has been successfully pierced (see California Div. Of Labor Standards Enforcement v. Dillingham Constr. N.A. Inc., 519 U.S. 316 (1997) and Duke v. U.S. Healthcare, Inc., 57 F.3d 350 (3rd Cir. 1995)), plaintiff attorneys have begun to use the ERISA statute itself to further litigation against managed care organizations. The court in Shea v. Esensten, 107 F.3d 625 (8th Cir. 1997), held in a landmark decision that an HMO's failure to disclose financial incentives that discourage a treating physician from providing essential health care referrals for conditions covered under the plan benefit structure is a breach of ERISA's fiduciary duties.

ERISA Preemption and Regulation of Managed Health Care: The Case for Managed Federalism

1997 ◽  
Vol 23 (2-3) ◽  
pp. 251-289
Author(s):  
Margaret G. Farrell
Keyword(s):  
Health Care ◽  
Retirement Income ◽  
Structural Reforms ◽  
Unborn Child ◽  
Income Security ◽  
Care Plans ◽  
Managed Health Care ◽  
Federal Statute ◽  
Managed Care Organizations ◽  
Retirement Income Security

The result ERISA compels us to reach means that the Corcorans [who lost their unborn child allegedly as a result of United Healthcare’s negligent determination that hospitalization was not medically necessary] have no remedy, state or federal, for what may have been a serious mistake. This is troubling....In the words of its sponsor, Senator Jacob Javits, the Employee Retirement Income Security Act (ERISA) was enacted in 1974 “to maintain the voluntary growth of private [pension and employee benefit] plans while at the same time making needed structural reforms in such areas as vesting, funding, termination, etc. so as to safeguard workers against loss of their earned or anticipated benefits....” Ironically, one of ERISA’s provisions—its indeterminate provision for the preemption of state law—has probably created more uncertainty about the adequacy and security of health care benefits than any other piece of legislation. Neither ERISA nor any other federal statute comprehensively regulates the content of employer provided health care plans, including benefits provided through managed care organizations (MCOs).

scholarly journals Retirement Income Security and Well-Being in Canada

2009 ◽  
Author(s):  
Michael Baker ◽  
Jonathan Gruber ◽  
Kevin Milligan
Keyword(s):  
Well Being ◽  
Retirement Income ◽  
Income Security ◽  
Retirement Income Security
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