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Physicians win two major legal victories in Florida

Physician Practice Advisor, November 1, 2006

Physicians won two significant legal victories in Florida this month that allow them to sue health insurers for slow or reduced payments, according to the American Medical Association (AMA).

In the first case, a state appellate court upheld the right of a Pompano Beach orthopedic surgeon to sue four insurers because of underpayments for out-of-network services. The physician contended that Florida's insurance laws create an implied private cause of action in favor of physicians and against insurers for payment of emergency medical services.

In another case, the Florida Supreme Court ruled that physicians could sue Humana and Blue Cross Blue Shield of Florida for late payment of their claims. The court ruled that an out-of-network physician may sue a health maintenance organization for failing to follow the state's prompt payment laws.

Click here to read more about the AMA's involvement in these cases.

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