Looks like some things are changing out there...a lawsuit not for denial of care, but rather phrased for fraud, misrepresenting the promise of benefits to the consumers...potential class action suit in the works as this article states...patients have been able to sue physicians but have not had much of a leg to stand on as far as responsibility of denying a life saving treatment to be shared by the insurers who hand down the decisions... BD
Lawsuits against managed care companies are beginning to happen now. The Illinois Supreme Court recently ruled that individuals can sue their health maintenance organizations (HMOs) for malpractice, according to court documents. This follows a landmark case where an Ohio jury awarded $51.5 million to a woman whose HMO would not pay for cancer chemotherapy. The woman died of the cancer.
Many of the most recent lawsuits are not for the denial of needed care - they are for fraud. The suits assert that many managed care companies misrepresent themselves to consumers. The companies are said to promise consumers a range of benefits, then to deny these same benefits to the consumers when they need them.
A new lawsuit appears to be around the corner. This one has already affected the stock prices of some HMOs, according to the Los Angeles Daily News. The article quotes Joseph Sellers, an attorney with Cohen, Milstein, Hausfeld & Toll in Washington, said he was "in the process of developing a class-action lawsuit against one of the nation's largest HMOs alleging fraud." The company has not been named, but Sellers said the lawsuit would claim that the HMO "is willfully misrepresenting the benefits it provides patients in an effort to maximize profits." After this story appeared Reuters reported that Aetna and Humana were both facing class action lawsuits.