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Court oks HMO malpractice suit. (ERISA).(health maintenance organizations)(Employee Retirement Income Security Act)
Federal law does not preempt a state malpractice action when an HMO denies coverage based on a patient's medical evaluation, even if the decision is also based on a legal evaluation of the insurance contract, a prominent federal appellate court held Feb. 11.
The Employee Retirement Income Security Act, which supercedes state laws that "relate to" benefits plans, has often been construed by courts as protecting health plans from state-court suits. But in Cicio v. Vytra Healthcare, a three-judge panel of the U.S. Court of Appeals for the 2nd Circuit said recent decisions by the United States Supreme Court have eroded that protection, thereby accomplishing through …
- Patients, families say court ruling insulates health plans from accountability.
- Newspaper article from: Newsday (Melville, NY) July 18, 2004 700+ words
...now? The U.S. Supreme Court's decision gave...resident and widow of Carmine Cicio last week. She filed...years ago in State Supreme Court in Riverhead against...lifeline. The U.S. Supreme Court decision did not address...
- Claims based on 'mixed eligibility and treatment' decisions not...
- Newspaper article from: Mealey's Litigation Report March 1, 2003 700+ words
...Denied In March 1997, Carmine Cicio, a participant in...the Suffolk County Supreme Court, naming as defendants...cell transplant for Carmine Cicio, the majority said...preemption, the U.S. Supreme Court has "[r]ejected...
- ERISA does not preempt state medical malpractice suit, Second Circuit rules.
- Magazine article from: Trial Porter, Rebecca April 1, 2003 700+ words
...was brought by the widow of Carmine Cicio, who was treated with chemotherapy...widow, citing the U.S. Supreme Court's decision in Pegram v...administered. In Pegram, the Supreme Court ruled for the defendant...decision, Boyle wrote that the Supreme Court did not reason ...
- BenefitNews.com Connect.(federal appeals court approves suits for HMO...
- Magazine article from: Employee Benefit News April 1, 2003 700+ words
...treatment decisions. The lawsuit was filed by the heirs of Carmine Cicio, who died of cancer in 1998. Cicio's physician prescribed...treatment because it was deemed experimental. Citing the 2000 Supreme Court decision in Pegram v. Herdrich, the court found that HMO...
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