216
Opinion of the Court
state-law fraud counts. The District Court granted their motion as to the second fraud count but granted Herdrich leave to amend the one remaining. This she did by alleging that provision of medical services under the terms of the Carle HMO organization, rewarding its physician owners for limiting medical care, entailed an inherent or anticipatory breach of an ERISA fiduciary duty, since these terms created an incentive to make decisions in the physicians' self-interest, rather than the exclusive interests of plan participants.3
3 The specific allegations were these: "11. Defendants are fiduciaries with respect to the Plan and under 29 [U. S. C. § ]1109(a) are obligated to discharge their duties with respect to the Plan solely in the interest of the participants and beneficiaries and
"a. for the exclusive purpose of: "i. providing benefits to participants and their beneficiaries; and "ii. defraying reasonable expenses of administering the Plan;
"b. with the care, skill, prudence, and diligence under the circumstances then prevailing that a prudent man acting in a like capacity and familiar with such matters would use in the conduct of an enterprise of a like character and like aims.
"12. In breach of that duty:
"a. CARLE owner/physicians are the officers and directors of HAMP and CHIMCO and receive a year-end distribution, based in large part upon, supplemental medical expense payments made to CARLE by HAMP and CHIMCO;
"b. Both HAMP and CHIMCO are directed and controlled by CARLE owner/physicians and seek to fund their supplemental medical expense payments to CARLE:
"i. by contracting with CARLE owner/physicians to provide the medical services contemplated in the Plan and then having those contracted owner/physicians:
"(1) minimize the use of diagnostic tests; "(2) minimize the use of facilities not owned by CARLE; and "(3) minimize the use of emergency and non-emergency consultation and/or referrals to non-contracted physicians.
"ii. by administering disputed and non-routine health insurance claims and determining:
"(1) which claims are covered under the Plan and to what extent; "(2) what the applicable standard of care is; "(3) whether a course of treatment is experimental;
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