Healthcare/Hospital Law
Mar. 21, 2009
Appellate Case Makes it Harder to Sue HMOs for Care Denials
A little noticed recent appellate ruling means patients who are denied care by a medical group's physician manager cannot sue their HMO. The health plans say they should not be liable for medical decisions; patient advocates counter that cost savings is the real motivation.
Daily Journal Staff Writer LOS ANGELES - The brain aneurysm that killed Elsie Martin was only partly to blame. Her doctor concluded the 67-year-old Whittier woman urgently needed surgery, but he was overruled by the medical group's managing physician. The medical group eventually relented, but it was too late. Martin died in 2004 when her aneurysm ruptured. The day she died, her husband returned home from the hospital to find a lett...
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