AETNA: Appeals Decision On Texas HMO Liability Law
In response to a state action, "Aetna Inc. has appealed a federal court's decision that upholds" a Texas law allowing injured patients to sue their HMOs. U.S. District Judge Vanessa Gilmore ruled Sept. 18 that the law was valid. But her ruling simultaneously "invalidated an independent review process for HMO members who are denied treatment by their" HMOs. Texas Attorney General Dan Morales (D) "appealed that portion of the decision earlier this month," the Dallas Morning News reports, prompting Aetna to file its action. Aetna had previously said it would not challenge the decision after agreeing to work with the state on reestablishing the independent review process (see CHL 9/23). But spokesperson Jill Griffiths said, "If the state had not appealed the decision, we would not have had to file the cross-appeal. ... We felt we needed the flexibility of the cross-appeal to be sure we could counter any issues raised by the state." The filing could potentially "tie up the case for months or years in the 5th U.S. Circuit Court of Appeals in New Orleans." Jamie Court, director of Consumers for Quality Care, said, "This is just a start-and-stall ... attempt to put a smiley face on a situation that clearly increases the leverage of the patient over the company. And no HMO or insurer wants that" (Ornstein, 10/27).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.