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Judge rules doctors in Florida can sue HMOs; insurers fighting decision
Physician Practice Advisor, May 25, 2005
A state appeals court in Florida has ruled that providers can sue insurers over charges of reduced or slow payments. Insurers intend to take the matter to the Supreme Court for reconsideration, according to The Miami Herald.
The providers claim they're entitled to receive their payment promptly and properly, while insurers say that if providers can sue HMOs, it could cause healthcare costs to climb. The debate stems from a state court case of a group of cardiologists suing several HMOs, including Humana and Blue Cross Blue Shield of Florida's Health Options.
Previous cases against HMOs involving payment and malpractice were thrown out, many based on a state Supreme Court decision that ruled that "all private causes of action," meaning plaintiff's lawsuits, are barred against HMOs, according to the Herald.
The state appeals court took the opposite stance, siding with the lawyers who "argued that common law indicated that rights of contract under general insurance law were applicable to the HMOs," according to the Herald.
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