Pegram's Regress: A Missed Chance for Sensible Judicial Review of Managed Care Decisions

Posted: 19 Feb 2002

See all articles by Michael T. Cahill

Michael T. Cahill

Brooklyn Law School

Peter D. Jacobson

University of Michigan School of Public Health

Abstract

This article argues that a proper interpretation of ERISA places fiduciary duties at the heart of its framework for judicial review, and that Pegram was therefore wrongly decided. The article also discusses the negative implications of Pegram. Essentially, the Supreme Court missed an opportunity to enable the use of ERISA to resolve managed care's serious allocative tradeoffs using the fiduciary-duty model of the kind the article proposes. Finally the article considers what, if anything, can be done after Pegram to maintain a balanced and significant role for the government, specifically the courts, in overseeing MCOs' decisions.

Suggested Citation

Cahill, Michael T. and Jacobson, Peter D., Pegram's Regress: A Missed Chance for Sensible Judicial Review of Managed Care Decisions. American Journal of Law & Medicine, Vol. 27, No. 4, Available at SSRN: https://ssrn.com/abstract=301181

Michael T. Cahill

Brooklyn Law School ( email )

250 Joralemon Street
Brooklyn, NY 11201
United States
718-780-7901 (Phone)
718-780-0376 (Fax)

HOME PAGE: http://www.brooklaw.edu/faculty//profile/?page=267

Peter D. Jacobson (Contact Author)

University of Michigan School of Public Health ( email )

109 Observatory
Ann Arbor, MI 48109-2029
United States
734-936-0928 (Phone)
734-764-4338 (Fax)

HOME PAGE: http://www.sph.umich.edu/~pdj/

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