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  Vol. 284 No. 12, September 27, 2000 TABLE OF CONTENTS
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The Supreme Court's View of the Managed Care Industry's Liability for Adverse Patient Outcomes

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In a recent article in THE JOURNAL,1 Mr Pomfret and I described the structure of the Federal Employee Retirement Income Security Act (ERISA) and how ERISA litigation reduces physician autonomy. In a subsequent development, the Supreme Court recently decided Pegram v Herdrich, 530 US_ (2000), a case that further addresses these issues.

Herdrich argued that she was not provided with an ultrasound diagnosis in a timely manner because her managed care plan's financial incentives encouraged her physician to delay the procedure. During the delay, her appendix ruptured, causing peritonitis. After being awarded $35,000 in state court, she sued under ERISA, arguing that the plan's financial incentives breached a fiduciary duty to act in the patient's best interests.

In a unanimous decision, the Court ruled that patients covered by an ERISA plan cannot sue to challenge managed care organizations' use of financial incentives. For now, the Court left . . . [Full Text of this Article]


RELATED ARTICLE

ERISA Litigation and Physician Autonomy
Peter D. Jacobson and Scott D. Pomfret
JAMA. 2000;283(7):921-926.
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