Mid-Atlantic Health Law TOPICS

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Did You Know? Spring 2004

Kansas Blues Acquisition Blocked: Did you know that the Kansas Supreme Court, in Blue Cross and Blue Shield of Kansas, Inc. v. Praeger, upheld the Kansas Commissioner of Insurance's refusal to approve Anthem Insurance Companies' proposed acquisition of Blue Cross and Blue Shield of Kansas? The court reasoned that the Commissioner's conclusion that the merger was not in the public interest should be given "great deference."
Doctors Suing Financial Managers: Did you know that a federal appellate court, in Wright v. Heyne, recently held that three physicians had waited too long to sue a financial manager under ERISA? ERISA is the federal statute that governs retirement plans, and it requires suits regarding breach of fiduciary duty to be brought within three years. Although the physicians had let less than three years pass from the time they learned that the misconduct might amount to an ERISA violation, they had let more than three years pass from the time they originally learned of the alleged misconduct. Some federal courts would have sided with the doctors in this controversy, but the federal appellate court with jurisdiction for Maryland has not yet decided the question.
Payments to Patients for Referrals: Did you know that a Tennessee appellate court, in Feldman v. Tennessee Board of Medical Examiners, recently upheld the Tennessee Board of Medical Examiners' discipline of a doctor who granted discounts to patients who referred other patients to the doctor? The doctor owned and operated a diet clinic, and had sent approximately eight thousand postcards to his patients, guaranteeing them a discount on service if they referred a friend. Although the doctor argued that the Board's decision infringed on his right to free speech, the court found that this type of speech was not protected, as it advocated an illegal activity - the "purchase" of medical referrals.


March 22, 2004




Rosen, Barry F.


Health Care