HMO LIABILITY: NC House Overwhelmingly Approves Measure
The North Carolina House yesterday "tentatively" approved 82-28 a measure that would enable the state's 1.6 million HMO enrollees to sue their plans if they "caused harm by overruling doctors' treatment decisions," the Raleigh News & Observer reports. Bill sponsor state Rep. Joe Hackney (D) said, "Physicians, nurses, any kind of medical-care personnel are accountable for their negligence. There is one notable exception -- that's HMOs." However, state Rep. John Hurley (D) predicts the bill would force HMOs to maintain a reservoir of funds to settle lawsuits, raising premiums by 8.6%. "We don't need this," Hurley said, adding, "A lot of people in North Carolina aren't going to be able to afford health insurance if we keep driving up the cost." However, Hackney pointed out that only two suits have been filed against HMOs in Texas, which in 1997 became the first state to approve an HMO liability law. But Paul Mahoney, executive director of the N.C. Association of Health Plans, countered that the law leaves plans vulnerable to lawsuits over treatments "that don't produce the expected results," adding that Texas "isn't an accurate gauge of the consequences of a liability law," as the law is only two years old and "the lawsuits filed were test cases." The House will take a final vote on the measure next year before sending it to the Senate (Bonner, 7/16).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.