Managed Care’s Responsibility for Decisions to Deny Benefits: the ERISA Obstacle
Appelbaum P S
In 1974 a federal law, the Employee Retirement Income Security Act (ERISA) was passed in the USA. This law affects all employee benefit plans including health care, & common law remedies such as suits alleging malpractice. This article presents the case of a widow who sued her insurance companies alleging that their failure to approve medically necessary treatment for her husband’s alcoholism contributed to his death by suicide. Her case was dismissed under the provisions of ERISA.