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1 (August 21, 2001)

handle is hein.crs/crsuntaaahk0001 and id is 1 raw text is: Order Code RS20868 Updated August 21, 2001 Employer Liability Provisions in Selected Patient Protection Bills Angie A. Welborn Legislative Attorney American Law Division Summary The liability of a self-insured employer in state court for group health plan related actions is generally preempted by ERISA. However, an employer who acts as the administrator of the health plan can be liable for breach of fiduciary duty under ERISA.1 Some federal courts have also found self-insured employers liable under theories of vicarious liability and direct negligence.2 The extent to which employers can be found liable in any of these situations varies depending on the employer's level of participation in the administration of the plan and the plan's decision making process regarding claims for benefits. In the various patient protection bills introduced in the 106th (H.R. 5628, S.Amdt. 3694, H.R. 2990) and to date in the 107th (H.R. 526, H.R. 2315, H.R. 2563, S. 889, S. 1052), Congress has attempted to address the issue of employer liability by limiting liability to certain persons or circumstances. This report provides an overview of the employer liability provisions of selected bills from the 106rh and 107rh Congress. In both the 106th and 107th Congress legislation has been introduced that would amend the Employee Retirement Income Security Act of 1974 (ERISA) to allow state or federal causes of action against group health plans for personal injury or wrongful death. Currently, ERISA preempts any and all State laws insofar as they may now or hereafter relate to any employee benefit plan...,,3 ERISA creates a civil enforcement scheme that 'See Hamilton v. Allen-Bradley Company, 217 F.3d 1321 (1Ith Cir. 2000). 2 Damon Henderson Taylor, ERISA Preemption: Will the Elimination of the ERISA Preemption Clause Help or Harm America's Ability to Deal with Its Pending Health Care Crisis?, 14 J.L. & Health 133, 160 (2000). See Cooney v. South Central Bell Telephone Company, 1992 WL 46381 (E.D. La.), Civ. A. No. 91-3870. ' 29 U.S.C. 1144. For a detailed discussion of ERISA preemption, see CRS Report 98-286, ERISA 's Impact on Medical Malpractice and Negligence Claims Against Managed Care Plans, (continued...) Congressional Research Service +. The Library of Congress CRS Report for Congress Received through the CRS Web

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