Abstract

On February 11, 2003, the Second Circuit ruled in Cicio v. Vytra Healthcare that patients may in some cases sue health maintenance organizations for medical malpractice under state law. The decision is particularly notable for opening the door to state tort claims in an area that had heen considered preempted by the Employee Retirement Income Security Act of 1974.ERISA is a federal statute that regulates employee benefit plans, establishing a complex set of rules and minimum standards for most health and pension plans in private industry. ERISA requires that participants receive certain information about their benefits plans, and imposes fiduciary responsibilities on individuals with discretionary control over plan assets. These individuals have certain specific duties, and are required to work “solely in the interest of the participants and beneficiaries and for the exclusive purpose of: providing benefits to participants and their beneficiaries; and defraying reasonable expenses of administering the plan.”