| Author | Subject: U.S. Supreme Court Rulings - Harder to Sue HMO's. Easier to Sue for Discrimination |
| Del | Posted At 18:01:15 06/19/2000
LAWYERS WEEKLY USA ALERT - DISCRIMINATION, HMOS The Supreme Court today made it easier to sue for discrimination but harder for patients to sue their HMOs. In the first case, the Court unanimously held that if an employer lies about the reason for a firing, the jury can simply infer that the real reason was discrimination - the plaintiff doesn't have to show direct evidence of discriminatory intent. The Court said that "a plaintiff's prima facie case, combined with sufficient evidence to find that the employer's asserted justification is false, may permit the trier of fact to conclude that the employer unlawfully discriminated... "Proof that the defendant's explanation is unworthy of credence is simply one form of circumstantial evidence that is probative of intentional discrimination, and it may be quite persuasive." The case is Reeves v. Sanderson Plumbing Products, Inc., No. 99-536. It is available at: http://supct.law.cornell.edu/supct/html/99-536.ZS.html In the second case, the Court unanimously held that an HMO can't be sued under ERISA for breach of fiduciary duty where it delayed sending a patient for treatment. The HMO in this case maintained a secret incentive plan that based doctors' bonuses on how much money they saved the HMO by limiting available treatment and tests. The plaintiff's appendix ruptured because the HMO delayed sending her to the hospital for an ultrasound. The patient argued that this constituted a breach of fiduciary duty under ERISA. But the Court said that "[t]he kinds of decisions...claimed to be fiduciary in nature are...mixed eligibility and treatment decisions...[W]e think Congress did not intend... any...HMO to be treated as a fiduciary to the extent that it makes mixed eligibility decisions acting through its physicians." The case is Pegram v. Herdrich, No. 98-1949. It is available at: http://supct.law.cornell.edu/supct/html/98-1949.ZS.html Be sure to read the next issue of Lawyers Weekly USA for in-depth analysis of what these decisions mean for practicing lawyers! This special "e-mail alert" service of Lawyers Weekly USA is provided exclusively to our subscribers who have registered to use the subscriber-only website benefits. It is designed to keep you up-to-the-minute on breaking news developments between issues. Please visit our website at http://www.lawyersweeklyusa.com Feel free to forward this e-mail alert to any colleagues who would be interested in this breaking news. Thanks to you, they'll have the opportunity to sample Lawyers Weekly USA for free by clicking on the following: http://www.lawyersweeklyusa.com/3freeusa.htm To comment on this service, or to request not to be contacted with future alerts, please e-mail us at comments@lawyersweekly.com |
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