-
1
-
-
17144416600
-
-
Roark v. Humana, Inc., 307 F.3d 298 (5th Cir. 2002)
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Roark v. Humana, Inc., 307 F.3d 298 (5th Cir. 2002).
-
-
-
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2
-
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17144374609
-
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Aetna Health Inc. v. Davila, 124 S.Ct. 2488 (2004)
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Aetna Health Inc. v. Davila, 124 S.Ct. 2488 (2004).
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-
-
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3
-
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0344624959
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Semi-Preemption in ERISA: Legislative Process and Health Policy
-
D.C. Schaffer and D.M. Fox, "Semi-Preemption in ERISA: Legislative Process and Health Policy," American Journal of Tax Policy 7, no. 1 (1988): 47-69; and L.E. Irish and H.J. Cohen, "ERISA Preemption: Judicial Flexibility and Statutory Rigidity," University of Michigan Journal of Law Reform 19, no. 1 (1985): 112-163.
-
(1988)
American Journal of Tax Policy
, vol.7
, Issue.1
, pp. 47-69
-
-
Schaffer, D.C.1
Fox, D.M.2
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4
-
-
17144411250
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ERISA Preemption: Judicial Flexibility and Statutory Rigidity
-
D.C. Schaffer and D.M. Fox, "Semi-Preemption in ERISA: Legislative Process and Health Policy," American Journal of Tax Policy 7, no. 1 (1988): 47-69; and L.E. Irish and H.J. Cohen, "ERISA Preemption: Judicial Flexibility and Statutory Rigidity," University of Michigan Journal of Law Reform 19, no. 1 (1985): 112-163.
-
(1985)
University of Michigan Journal of Law Reform
, vol.19
, Issue.1
, pp. 112-163
-
-
Irish, L.E.1
Cohen, H.J.2
-
5
-
-
17144367785
-
-
Alessi v. Raybestos-Manhattan, Inc., 451 U.S. 504, 523 (1980)
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Alessi v. Raybestos-Manhattan, Inc., 451 U.S. 504, 523 (1980).
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-
-
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6
-
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17144371080
-
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Shaw v. Delta Airlines, 463 U.S. 85, 96-97 (1983)
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Shaw v. Delta Airlines, 463 U.S. 85, 96-97 (1983).
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-
-
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7
-
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17144371601
-
-
Ibid., at 105
-
Ibid., at 105.
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-
-
-
8
-
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17144381779
-
-
Metropolitan Life Insurance Company v. Massachusetts, 471 U.S. 724, 740-744 (1985)
-
Metropolitan Life Insurance Company v. Massachusetts, 471 U.S. 724, 740-744 (1985).
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-
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9
-
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17144392291
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-
473 U.S. 134 (1985)
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473 U.S. 134 (1985).
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-
-
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10
-
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17144361893
-
-
Massachusetts Mutual Life Insurance Co. v. Russell, 473 U.S. 134, 146 (1985)
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Massachusetts Mutual Life Insurance Co. v. Russell, 473 U.S. 134, 146 (1985).
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-
-
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11
-
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17144384871
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481 U.S. 41 (1985)
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481 U.S. 41 (1985).
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-
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12
-
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17144382582
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Ibid., at 52
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Ibid., at 52.
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13
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17144425474
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Ibid., at 56
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Ibid., at 56.
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14
-
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17144376160
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Ibid., at 57
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Ibid., at 57.
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15
-
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17144411251
-
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481 U.S. 58, 63-67 (1987)
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481 U.S. 58, 63-67 (1987).
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-
-
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16
-
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17144409730
-
-
See Wickline v. State of California, 239 Cal. Rptr. 810 (Cal. App. 1982); and Hughes v. Blue Cross of Northern California, 263 Ca. Rptr. 85 (1989)
-
See Wickline v. State of California, 239 Cal. Rptr. 810 (Cal. App. 1982); and Hughes v. Blue Cross of Northern California, 263 Ca. Rptr. 85 (1989).
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17
-
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17144411603
-
-
See Corcoran v. United Healthcare, Inc., 965 F.3d 1321 (5th Cir. 1992)
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See Corcoran v. United Healthcare, Inc., 965 F.3d 1321 (5th Cir. 1992).
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18
-
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17144418220
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Andrews-Clarke v. Travelers Insurance Company, 984 F.Supp. 49 (D. Mass. 1997)
-
This rage is perhaps clearest in the eloquent decision of Judge William Young in Andrews-Clarke v. Travelers Insurance Company, 984 F.Supp. 49 (D. Mass. 1997).
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-
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19
-
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17144432397
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514 U.S. 645 (1995)
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514 U.S. 645 (1995).
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-
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20
-
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17144409521
-
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Pegram v. Herdrich, 530 U.S. 211, 235-237 (2000)
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Pegram v. Herdrich, 530 U.S. 211, 235-237 (2000).
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-
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21
-
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17144414243
-
-
Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355, 378 (2002)
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Rush Prudential HMO, Inc. v. Moran, 536 U.S. 355, 378 (2002).
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-
-
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22
-
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17144408091
-
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Estate of Frappier v. Wishnov, 678 S0.2d 884 (Ct. App. 1996)
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Estate of Frappier v. Wishnov, 678 S0.2d 884 (Ct. App. 1996).
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-
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23
-
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17144375800
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57 F.3d 350 (3d Cir. 1995)
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57 F.3d 350 (3d Cir. 1995).
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-
-
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24
-
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17144381047
-
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Cicio v. Does 1-8, 321 F.3d 83 (2003); and Pappas v. Asbel, 564 Pa. 407, 786 A.2d 1089 (Pa. Sup. Ct. 2001)
-
Cicio v. Does 1-8, 321 F.3d 83 (2003); and Pappas v. Asbel, 564 Pa. 407, 786 A.2d 1089 (Pa. Sup. Ct. 2001).
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-
-
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25
-
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17144393047
-
-
Pryzbowski v. U.S. Healthcare, 245 F.3d 266 (3d Cir. 2001) (sec. 502); Haynes v. Prudential Health Care, 313 F.3d 330 (5th Cir. 2002) (sec. 514); Marks v. Watters, 322 F.3d 316 (4th Cir. 2003) (sec. 502); DeFelice v. Aetna U.S. Healthcare, 346 F.3d 442 (3d Cir. 2003) (sec. 502); Thompson v. Gencare Health Systems, Inc., 202 F.3d 1072 (8th Cir. 2000) (sec. 502); and Howard v. Coventry Health Care of Iowa, 293 F.3d 442 (8th Cir. 2002) (sec. 514)
-
Pryzbowski v. U.S. Healthcare, 245 F.3d 266 (3d Cir. 2001) (sec. 502); Haynes v. Prudential Health Care, 313 F.3d 330 (5th Cir. 2002) (sec. 514); Marks v. Watters, 322 F.3d 316 (4th Cir. 2003) (sec. 502); DeFelice v. Aetna U.S. Healthcare, 346 F.3d 442 (3d Cir. 2003) (sec. 502); Thompson v. Gencare Health Systems, Inc., 202 F.3d 1072 (8th Cir. 2000) (sec. 502); and Howard v. Coventry Health Care of Iowa, 293 F.3d 442 (8th Cir. 2002) (sec. 514).
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-
-
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26
-
-
0242595945
-
What ERISA Means by 'Equitable': The Supreme Court's Trail of Error in Russell, Mertens, and Great-West
-
See Cicio v. Does, 321 F.3d 83, 105 (2d Cir. 2002) (Calabrezi, J., dissenting in part); and Defelice v. Aetna U.S. Healthcare, 346 F.3d. 442, 453 (3d Cir. 2003) (Becker, J., concurring)
-
See Cicio v. Does, 321 F.3d 83, 105 (2d Cir. 2002) (Calabrezi, J., dissenting in part); and Defelice v. Aetna U.S. Healthcare, 346 F.3d. 442, 453 (3d Cir. 2003) (Becker, J., concurring). Both cases cited J. Langbein, "What ERISA Means by 'Equitable': The Supreme Court's Trail of Error in Russell, Mertens, and Great-West," Columbia Law Review 103, no. 6 (2003): 1317-1366.
-
(2003)
Columbia Law Review
, vol.103
, Issue.6
, pp. 1317-1366
-
-
Langbein, J.1
-
27
-
-
17144387613
-
-
note
-
Davila also suggests that employers do not have to worry about being held liable for coverage decisions made by employee benefit plan administrators, as they are further removed from treatment decisions.
-
-
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28
-
-
17144429824
-
-
124 S.Ct. at 2503, quoting Defelice v. Aetna U.S. Healthcare
-
124 S.Ct. at 2503, quoting Defelice v. Aetna U.S. Healthcare.
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-
-
-
29
-
-
17144417824
-
-
note
-
It is possible that Davila would not bar a state statute subjecting all managed care plans to liability for the negligent treatment decisions of their contracting physicians. Such a law would clearly be preempted by section 514, however, and would probably not be a law regulating insurance saved from preemption. It is also possible that state litigation could be brought after Davila claiming that an ERISA plan was negligently designed insofar as it created improper incentives for physicians. These claims have rarely been successful, and the Court in Pegram seemed skeptical about plan-design claims against ERISA plans. Also, Davila itself involved a negligent formulary design claim, although the Court did not characterize it as such. Finally, lawsuits against plans for negligent selection of providers might still be possible after Davila, although, again, these claims could be characterized as challenging coverage determinations.
-
-
-
-
30
-
-
17144420956
-
-
29 U.S.C. 1104(a)(1)
-
29 U.S.C. 1104(a)(1).
-
-
-
-
31
-
-
1842780071
-
A Quiet Revolution: Law as an Agent of Health System Change
-
M.G. Bloche and D. Studdert, "A Quiet Revolution: Law as an Agent of Health System Change," Health Affairs 23, no. 2 (2004): 29-42.
-
(2004)
Health Affairs
, vol.23
, Issue.2
, pp. 29-42
-
-
Bloche, M.G.1
Studdert, D.2
|