Volume 12 - Issue 12 - December 2004

I n the first two articles of this series, I discussed ERISA and how ERISA insulates insurance companies from liability from litigation by patients. This is so because the Supreme Court interpreting ERISA has used as its guiding principle of judicial interpretation that paying for care and providing care are wholly distinct. Sometimes, of course, the Supreme Court has required insurance companies to adhere to the terms of their contracts, for example by requiring them to account for patients to receive second opinions. I have explained that even if states attempt regulation of HMOs with