BENEFIT DENIALS AND ERISA PREEMPTION: THE ONGOING STORY

ROBERT N. COVINGTON


DOI: 10.2190/DKBG-4HPV-WYUH-QF8Y

Abstract

Recent Supreme Court decisions involving ERISA (1) have increased the scope of power that state legislatures can exercise to regulate the decision-making procedures of health care providers, particularly HMOs, that lead to granting or denying benefits; but also (2) have made it increasingly difficult for patients and their families to recover meaningful damages under state or federal law for wrongful denials of treatment. Language in individual justices' opinions reveal a potential sharp split over the remedies courts may provide for benefit denials under the language of section 502 of ERISA authorizing "other appropriate equitable relief."

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