LAT: How Supreme Court HMO Decision Affects Patients

Q&A
How the Decision Affects Patients

By Lisa Girion, Times Staff Writer


The Supreme Court's ruling Monday that severely limits some consumers' ability to sue their health insurers was hailed by the industry as a big step toward holding down healthcare costs and decried by consumer advocates as an impingement on patients' rights.

Here are answers to questions consumers might have about the decision.

Question: What does the ruling mean?

Answer: It means that many HMO members cannot sue their health plans in state courts for denying treatment. California is one of 10 states that had enacted laws allowing HMO members to sue health plans over treatment denials. Those state laws are essentially wiped out by this ruling....

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Q: Does this block all lawsuits over insurance payments?

A: No. It applies only to HMO coverage provided by a private employer. People who buy their own HMO coverage or obtain it through a job in government or with a religious institution are not affected. The ruling also does not affect people in Medicare HMOs, who may sue their plans and recover punitive damages, as well as compensation for pain and suffering.

Q: What recourse do affected HMO members have now?

A: In 42 states, including California, HMO treatment decisions are still subject to independent review. In California, HMO members may appeal a treatment denial to the state Department of Managed Health Care....


http://www.latimes.com/news/nationworld/nation/la-fi-hmo22jun22,1,7261019.story?coll=la-home-headlines

Does this smack of inequality of care and treatment?

Employers will listen to the employees and look for alternatives to the HMO Industry to for quality health-care since a patient can't sue to "save your life."

Just another good idea that's been corrupted by the GOP to earn more for less.

If we are unable to sue if treatment is denied Whats the point of having insurance at all? Now instead of paying for assembly line medicine.. We get to pay for nothing... Our employers don't care as long as it is not coming out of their pockets and this will keep their costs down, not the little guys.