the Sugar Conspiracy

Tuesday, June 22, 2004

Surprise! HMOs win again!

Monday's high court ruling means patients like Calad can't seek hefty damage awards in court if their HMOs refuse to pay for doctor-recommended medical care. The unanimous decision rejected arguments that the threat of multimillion-dollar lawsuits keeps insurance companies honest, invalidated an important part of patient rights laws in several states and tossed a political hot potato back to Congress, where lawmakers repeatedly have tried and failed to pass national patient protections.

"I hope this ruling breathes new life into the patients' bill of rights debate in Congress," Calad said. "I'm also hoping they do not just sweep this under the rug and completely forget about it."

The court said HMOs are shielded from lawsuits in state courts, where juries are more apt to side with victims and recommend multimillion-dollar judgments from insurance companies.

Justice Clarence Thomas, who wrote Monday's ruling, relied on a federal pension benefit law that predates the rise of managed care and said patients may pursue claims only in federal courts, where awards are capped at only the cost of medical services the HMO would not cover.

Story.

posted by chris at 2:25 PM
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