2nd Circuit Panel: Doctor’s Suit Against Insurer Not Completely Preempted By ERISA

Mealey's (May 23, 2017, 8:58 AM EDT) -- NEW YORK — A Second Circuit U.S. Court of Appeals panel on May 18 held that the Employee Retirement Income Security Act does not completely preempt an “out-of-network” health care provider’s promissory estoppel claim against a health insurer where the provider did not receive a valid assignment for payment under the health care plan and received an independent promise from the insurer that he would be paid for certain medical services provided to the insured, saying that any legal duty the insurer has to reimburse the provider is independent and distinct from its obligations under the patient’s plan (McCulloch Orthopaedic Surgical Services PLLC a/k/a Dr. Kenneth E. McCulloch v. Aetna Inc., et al., No. 15-2150, 2nd Cir., 2017 U.S. App. LEXIS 8694)....