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June 22, 2004 - 8704 subscribers
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(Please visit our sponsors. We try to make sure their products and services will be of interest to you. Thanks! --Editor)
Text of 26-Page Slip Opinion in Supreme Court Case Holding ERISA Preempts Texas HMO Negligence Law (PDF)
Excerpt: "Respondents brought separate Texas state-court suits, alleging that petitioners, their health maintenance organizations (HMOs), had re-fused to cover certain medical services in violation of an HMO's duty 'to exercise ordinary care' under the Texas Health Care Liability Act (THCLA), and that those refusals 'proximately caused' respondents' injuries." (U.S. Supreme Court)

New York Times Coverage: Justices Limit Ability to Sue Health Plans
Excerpt: "The Supreme Court on Monday unanimously rejected efforts by states to give patients in managed care a right that Congress has so far declined to provide: the ability to sue managed-care companies for damages for refusing to cover treatment that a doctor has deemed medically necessary." (New York Times; one-time registration required)

Washington Times Coverage: High Court Shields HMOs from Malpractice
Excerpt: "Eleven states have enacted patient-protection laws, but they set varying standards for liability. Insurers try to avoid state courts because the juries often grant larger awards to people they perceive as victims of corporations compared with disputes between individuals." (Washington Times)

Seattle Post-Intelligencer Coverage: High Court Curbs Big-Dollar Lawsuits Against Insurers
Excerpt: "The U.S. Supreme Court dealt a major blow to Washington state's 'Patient's Bill of Rights' yesterday, ruling in effect that patients can't bring multimillion-dollar lawsuits when insurers refuse to pay for recommended medical treatment." (Seattle Post-Intelligencer)

How the Supreme Court ERISA Preemption Decision Affects Patients
Excerpt: "California is one of 10 states that had enacted laws allowing HMO members to sue health plans over treatment denials. Those state laws are essentially wiped out by this ruling." (Los Angeles Times; one-time registration required)

NPR Coverage: Marcia Coyle of the National Law Journal About HMO Malpractice Law Preemption Case
Excerpt: "Justice Ginsberg wrote a concurring opinion in which she said that even though she agreed with the court's decision there's a real inequity developing here in how ERISA is being interpreted by the courts and playing out in the courts. Because the Supreme Court has interpreted ERISA pre-exemption broadly and the remedies under ERISA narrowly ..." (National Public Radio)

AP Coverage: Supreme Court Rules for HMOs in Patient Lawsuits
Excerpt: "The court said HMOs are shielded from lawsuits in state courts, where juries are more apt to side with victims and recommend multimillion-dollar judgments from insurance companies." (AP via Washington Post; one-time registration required)

Houston Chronicle Coverage: Court Ruling Favors HMOs
Excerpt: "Patients claiming harm from their HMOs' refusal to pay for medical treatment ordered by their doctors cannot sue in state court, where they could collect large amounts of money, a unanimous U.S. Supreme Court ruled Monday in two Texas cases." (Houston Chronicle)

Business Group Praises Supreme Court Decision
Excerpt: "The Texas Association of Business is praising a U.S. Supreme Court decision that determined managed care lawsuits rightly belong in federal court-- a move that TAB says will bar personal injury trial lawyers from chasing a cash cow." (Houston Business Journal via bizjournals.com; one-time registration required)

Opinion: Patients Now Have Fewer HMO Rights than President Bush and Congress
Excerpt: "President Bush's support of the HMOs' case violates promises he made while campaigning for the presidency to protect state patient rights laws including a 1997 Texas law. Since the Texas law went into effect, 10 other states (California, Georgia, Washington, Arizona, Maine, Oklahoma, West Virginia, New Jersey, North Carolina, and Oregon) have passed similar legislation allowing patients the 'right to sue' when they are harmed by a health insurer." (Foundation for Taxpayer & Consumer Rights)

Opinion: HMOs Win, Patients Lose and Congress Stays In Coma
Excerpt: "For the third time since 1987, the court ruled that federal law prohibits patients from suing HMOs in state courts for malpractice. But in handing the insurance industry a victory in this dispute over refusing to pay for care recommended by doctors, the court did the nation a favor. It called attention to Congress' failure to enact legislation ..." (USA Today)

Opinion: Court Decision Takes HMOs off the Hook from Improper Denials of Health Care
Press release. Excerpt: "Today's Supreme Court decision takes HMOs off the hook from any liability when they deny needed health care - even when improper denials have tragic consequences. This means that health plans will no longer be deterred from making improper decisions that could severely harm patients." (Families USA)

Opinion: Supreme Court Ruling Reins in Trial Lawyers
Excerpt: "America's health care system is confronting major challenges. The ranks of the uninsured are growing. Costs continue to escalate. Patients are receiving care based on the best scientific evidence only about half the time. Rather than devise new ways for trial lawyers to plunder the health care system, Congress should pursue innovative policies that foster public-private collaboration to expand access, restrain costs and enhance quality. That's real patient protection." (Karen M. Ignagni of the America's Health Insurance Plans, in USA Today)

Links to Items on Executive Comp, Benefits in General

IRS Draws a Bead on Executive Compensation
Excerpt: "The IRS means business. Following up on the original examination, which was limited to a general closer scrutiny of executive benefits, the IRS identified eight areas for heightened oversight: ..." (PLANSPONSOR.com; one-time registration required)

IRS to Probe Pay of Some Charities' Executives
Excerpt: "The Internal Revenue Service plans to investigate the 'seemingly high compensation' paid to leaders of some tax-exempt and charitable organizations, the agency's commissioner said Tuesday." (AP via Washington Post; one-time registration required)

Overview: House Approves International Tax Bill with Changes to Nonqualified Deferred Comp Rules
Excerpt: "The House bill would amend the Internal Revenue Code to add a new section 409A to provide specific rules for taxing compensation deferred under nonqualified deferred compensation plans. In general, participants would be required to include such compensation in gross income when deferred (or when no longer subject to a substantial risk of forfeiture, if later) unless the plan at all times satisfied specific requirements." (Deloitte's Washington Bulletin)

Newly Posted Events

Getting It Right – Know Your Fiduciary Responsibilities
in Massachusetts on September 8, 2004
presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Great Lakes Benefits Conferences
in Illinois on May 5, 2005
presented by ASPA (American Society of Pension Actuaries)

Joint ASPA and WP&BC Conference
in California on July 24, 2005
presented by ASPA (American Society of Pension Actuaries)

Los Angeles Benefits Conference
in California on January 27, 2005
presented by ASPA (American Society of Pension Actuaries)

New Distribution Rules for Defined Benefit Plans Webcast
Nationwide on September 22, 2004
presented by ASPA (American Society of Pension Actuaries)
Newly Posted Press Releases

International Foundation Launches Monthly Benefits & Compensation Digest
(International Foundation (of Employee Benefit Plans, or IFEBP))

Something new is available from NCPERS: Group Long Term Care Insurance.
(National Conference on Public Employee Retirement Systems)

Gilsbar, Inc. and MedCom Care Management, Inc. Welcome New Vice President
(Gilsbar, Inc.)

Council welcomes unanimous Supreme Court ruling in Davila and Calad ERISA cases
(American Benefits Council)

Supreme Court Ruling on Health Care Claims Raises Important Policy Issues: American Benefits Council Responds to Critics of Today's Davila, Calad Rulings
(American Benefits Council)

Incentives for Long-Term Care Insurance Included in Senate Bill on Alzheimer's Research
(American Council of Life Insurers)

Class I Almost Sold Out! Class II Announced... Leading in an Ownership Setting: The Program for CEOs
(ESOP Association)

CIGNA Statement Regarding U.S. Supreme Court's Unanimous Decision Upholding ERISA Preemption of State Laws
(CIGNA Corporation)

McCready and Keene Discloses Fees to Investment Advisors
(McCready & Keene, Inc.)

Peoria-Area Retirement Plan Professional Promoted At Alliance Benefit Group of Illinois
(Alliance Benefit Group of Illinois)
Movers and Shakers: Newly Posted Announcements of Promotions and New Personnel
(Post Yours!)

Jackie Kingsbury and Chris Baker (Pension Resource Group)
Newly Posted or Renewed Job Openings
Post a Help Wanted Ad

Director of Pension Administration
for Associated Pension Consultants
in CA

Lateral Attorney
for Slevin & Hart, P.C.
in DC

Atlanta Recordkeeping Manager
for AMVESCAP Retirement, Inc.
in GA

Pension Administrator
for Snyder Cohn
in MD

Small Business 401(k) Sales
for Wells Fargo Bank
in CA, IA, OR, UT, WA, WI

Attorney
for Norfolk Southern Corporation
in VA

401(k) Compliance Specialist
for TPA Firm in Southeastern MI
in MI

Senior Employee Benefits Attorney
for Citistreet
in FL

Defined Contribution Administrator
for Pension Performance, Inc.
in IL

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