Plaintiffs who sue health maintenance organizations in state court face a daunting legal barrier: the Employee Retirement Income Security Act (ERISA), which governs most employer-paid medical plans. In suits involving such plans, ERISA packs a double whammy � it limits HMOs’ liability and it largely preempts state law theories of liability.

On April 9, though, the 5th U.S. Circuit Court of Appeals gave plaintiffs some ammunition against ERISA. In Giles v. NYLCare Health Plans Inc. et al., the court granted federal courts broader authority to remand negligence claims against HMOs to state courts to decide whether ERISA preempts state law. And most plaintiffs would prefer that state judges decide whether a claim is preempted, says George Parker Young, Giles’ attorney.