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Pryzbowksi v. U.S. Healthcare, Inc.

District Court correctly held that plaintiff's claims against her HMO for negligently and carelessly delaying approval of her back surgery fell within the realm of administration of benefits and were, therefore, preempted by ERISA; however, court erred in finding that plaintiff's claims against individual doctors were expressly preempted as a matter of law.

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Argued: November 14, 2000

OPINION OF THE COURT

Before us is Linda Pryzbowski’s appeal of two orders of the United States District Court for the District of New Jersey: (1) the December 3, 1997 order dismissing her claims against U.S. Healthcare for its delay in approving requested services after determining that those claims were completely preempted under S 502(a) of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. S 1132(a)(1)(B); and (2) the September 8, 1999 order granting summary judgment on the state law claims in favor of the remaining defendants, Medemer ge, P.A. and Dr. John Pilla, Dr. Carol E. Sgambelluri, and Dr. Kent R. Ellis (“the physician defendants”), on the ground that those claims were expressly preempted byS 514(a) of ERISA, 29 U.S.C. S 1144(a). See Pryzbowski v. U.S. Healthcare, Inc., 64 F. Supp. 2d 361 (D.N.J. 1999).

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