ABSTRACT:
In recent years, courts have applied the Employee Retirement Income Security Act of 1974 ("ERISA ") to pre-empt an increasingly wide scope of state laws, with the effect of limiting remedies of plan participants and beneficiaries and frustrating state health care reform efforts. Professor Jordan argues that the recent Supreme Court decision in New York State Conference of Blue Cross & Blue Shield v. Travelers Insurance Co. is a signal from the Court that ERISA pre-emption should be applied more narrowly. She first analyzes the Court's prior pre emption decisions and identifies delimiting language unheeded by lower courts. She then explores the impact of Travelers on ERISA preemption analysis, finding the decision renews emphasis on the historical presumption against pre empting laws within state police power and takes a more pragmatic approach to discerning congressional intent regarding ERISA pre emption. Finally, by examining certain emerging pre emption issues, namely those involving provider taxes and contract and tort claims she assesses the effectiveness of the analytical framework derived from Travelers and prior Supreme Court cases in restraining the scope of ERISA pre-emption. Professor Jordan concludes that the framework can effectively restrain findings of pre-emption and should lead to more rational pre-emption decisions.
ABSTRACT:
A growing number of working Americans receive their health care through HMO-administered employee health benefit plans. ERISA preempts state common law medical malpractice claims brought by injured employee-beneficiaries and their dependents against these HMOs. While federal courts have generally deprived plaintiffs of these medical malpractice claims, federal district courts are split over the question of whether ERISA preempts HMO malpractice claims based on a vicarious liability theory. In PacifiCare of Oklahoma, Inc. v. Burrage, the Third Circuit became the first circuit court to explicitly consider the question. The PacifiCare court upheld an ostensible agency malpractice claim against an HMO's ERISA preemption challenge.
This Comment argues that notwithstanding the Third Circuit's proper result in restraining ERISA preemption of HMO medical malpractice claims based on a vicarious liability theory, the court's approach has serious shortcomings. The Third Circuit misconstrues the nature of the vicarious liability medical malpractice claim, creates a legal paradox within the field of ERISA preemption, and adheres to ERISA's text at the expense of its purpose. This Comment proposes that future courts adopt a broader-based approach to ERISA preemption of medical malpractice claims. This broad-based approach should be more consistent with ERISA's purpose, give proper regard to the presumption against preemption and traditional state powers, and better reflect the policy concerns of equity and quality in our health care system. This Comment concludes that Congress should amend ERISA to limit its preemptive effect in the health care field.
Copyright 1996 University Law Review Project
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University Law Review Project
Health Law Abstracts
AREA 18 Issue 8
July 21, 1996
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