Managed Care Plan Accountability Act of 1997
- If any ERISA plan connected HMO makes a medically innappropriate
decision because of cost-containment, or otherwise restricts the
treating doctors' full medical discretion, the plan sponsor and
the HMO shall be jointly and
severally liable for compensatory and consequential proximate
damages, and at the court's discretion, punitive damages.
- Remedies under this paragraph are in addition to remedies
otherwise provided under ERISA, ie: equitable remedies for
denial of benefits.
- State courts shall have concurrent jurisdiction over such actions.
- The plan must also indemnify providers for any liability
resulting from failure to provide a benefit as a direct result
of plan restrictions on doctor/patient communication.
- Such actions by any managed care plan will also result in
adverse tax consequences for the plan.