ERISA: NY Court Rules Docs in HMOs Can Be Sued
In a ruling "that could make it easier for patients to bring malpractice suits against doctors in managed care" plans, the New York Court of Appeals determined yesterday that ERISA does not protect doctors in HMOs from malpractice suits. The ruling came in a suit in which the widow of a man who died of a heart attack charged that his primary care doctors delayed processing paperwork that would have allowed him to see a cardiologist, the New York Times reports (Finder, 3/26). It took Glenn Nealy, who was enrolled in U.S. Healthcare, nearly five weeks after first complaining of chest pain to be referred to a cardiologist. He died of a massive heart attack the night before he was scheduled to see one (Young/Rabin, Newsday, 3/26). "It's clear that Congress did not intend to pre-empt claims such as those now before us," ruled Chief Judge Judith Kaye. The court did, however, remove U.S. Healthcare and two other subsidiaries from the suit because of ERISA protections (New York Times, 3/26). Newsday reports that the "ruling comes as courts are narrowing their interpretations of the pre-emptions provided by ERISA." David Trueman, a New York lawyer who specializes in HMO litigation, said, "The New York Court of Appeals is saying there are some limits to what ERISA can pre-empt" (3/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.