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The HMO’s Don’t Want To Pay It- But Medical Malpractice Suits Continue

It is possible to claim against doctors that work at Health Maintenance Organizations (HMO) but it is very difficult to sue the HMO itself.

HMOs claim to be protected by Federal Law, under the Employee Retirement Security Act of 1974. However certain lawyers have made a business out of representing clients who had problems with their HMOs including HealthNet, Humana, Aetna, Regence, and Kaiser.

When you sign on as part of your HMO contract that Medical Malpractice cases must go to binding Arbitration it is still in your interest to get a lawyer for better results.

Republican leaders in the Maryland legislature say a 2% HMO tax will help pay for medical malpractice cases.

The tax subsidizes payments to malpractice insurers in order to keep malpractice insurance low enough for doctors in Maryland to pay, and not be forced to leave their profession, or the state.

Optimum Choice, Aetna Health, and United Healthcare said they would have to raise premiums. The Medical Mutual Liability Insurance Society of Maryland collected more than $27 million in 2005 through a subsidy funded by the HMO tax. The Democrats, who passed this bill over Governor Ehrlichs veto, say the bill works, as the goal of the bill is to not overly oppress doctors with medical malpractice fees.

In Utah, State Senator Peter Knudson is writing a malpractice law that would stop claims against volunteer medical workers who receive some compensation for providing charity care services.

The dispute continues in courts in Florida, on whether the ERISA law protects all HMOs from medical malpractice cases. Florida courts have tended to side with the position that if the HMOs are sued for negligent care they may be liable, but if they are sued for an internal decision on what medical procedure they would be willing to pay for, then they are protected by ERISA.