WASHINGTON, June 29, 2023 – The ERISA Industry Committee (ERIC) joined with two like-minded groups on Wednesday to file an amicus brief with the Ninth Circuit Court of Appeals in Bristol SL Holdings, Inc. v. Cigna Health & Life Ins. Co. The brief urges the Court to affirm the previous ruling by the U.S. District Court for the Central District of California that determined the state law breach of contract and promissory estoppel claims at issue are preempted by the Employee Retirement Income Security Act (ERISA).
The case involves a now bankrupt out-of-network mental healthcare treatment center that violated the terms of the plan but demanded plan payment. The provider’s successor sued, arguing there was a promise to pay for medical treatment even before treatment was given. The main question in this case is whether these state-law claims are preempted by federal ERISA law.
The filing by ERIC and its coalition partners specifically focuses on the legal framework of ERISA preemption to protect national uniformity on central plan design decisions, and the substantial, real-world impacts of this and related lawsuits.
“The District Court ruling in Bristol SL Holdings, Inc. v. Cigna Health & Life Ins. Co. strongly reinforces ERISA preemption precedent and protects large employers from a wave of costly nuisance litigation that could result from an overturned ruling on appeal,” said James Gelfand, President and CEO of ERIC. “This case is a critical opportunity to illustrate the substantial real-world impact that this kind of litigation has on plan administrators and demonstrates how such claims fundamentally interfere with the pre-authorization system meant to prevent unnecessary and excessive out-of-network expenditures. If these state claims are allowed to continue, and incentives to seek more economical care are destroyed, the entire managed care paradigm could be undermined.”
The text of the brief can be found here.