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Article: MCO patients cannot sue: US Supreme Court rules.(Managed Care Organizations)
- Article from:
- Pharma Marketletter
- Article date:
- June 28, 2004
CopyrightCOPYRIGHT 2004 Marketletter Publications Ltd. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)
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The US Supreme Court has rejected a bid by Texas and nine other states to allow patients to obtain damages from their managed care organizations if they are refused treatment which a doctor has said is medically necessary.
Reversing a 2002 appeal court decision, the Supreme Court ruled that state laws are pre-empted by the 1974 Employee Retirement Income Security Act, under which patients may sue for reimbursement but not for damages relating to benefits denied to them by their managed care provider.
Central to the suit are two Texas cases, one of which, Aetna Health versus Davila, involved a patient whose doctor prescribed him Merck & Co's COX-2 ...