ERISA: Is The Wall Crumbling Down?
Today's Wall Street Journal examines recent court rulings that have put a chink in the ERISA armor that HMOs have long enjoyed. The Journal notes that the rulings "mark a major shift in liability exposure facing managed-care providers," and that HMOs are "becoming exposed to lawsuits for cost-cutting medical decisions, such as the denial of additional testing or specialized treatment, that result in injury." While those in the industry say allowing patients broad leeway to sue health plans -- which is currently under consideration in Congress and at least 30 states -- would drive up health costs, patient advocates say the cost "would be worth it." One lawyer who specializes in suing HMOs said, "The American public would be willing to pay a few dollars more to have the assurance that managed-care companies will be sued if they provide care that costs their loved ones their lives" (Geyelin, 4/30).
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.