SUPREME COURT: Reluctant to Let Patients Sue HMOs
The Supreme Court yesterday seemed wary of allowing patients to sue health plans that give physicians financial incentives to control costs, hearing a case that argues such arrangements violate physicians' "fiduciary duty" under the Employee Retirement Income Security Act to act in patients' best interests, the Los Angeles Times reports. The justices suggested that giving patients the right to sue HMOs in federal court is better left to Congress and questioned whether the courts should be involved in determining what constitutes an improper financial arrangement between an HMO and a physician. "Why should the courts get into this slippery slope problem? Why should the courts get involved in this messy business of what is an undue (financial) arrangement?" Justice Sandra Day O'Connor asked. The court also seemed receptive to the argument that making such financial incentives illegal would affect a health plans' ability to control costs. A final decision is expected in July (Rubin, 2/24).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.