Attorneys for HMO Managed Care Negligence

Ohio law regarding patients' rights to hold their HMOs for the services they contract to provide is continuously changing. At the law firm of Elk & Elk, we bring claims on behalf of our clients when appropriate care has been denied or negligently provided. If you have been the victim of HMO malpractice, our medical malpractice attorneys have the experience and expertise to help you.

 

Our team of HMO Managed Care Negligence attorneys offers the medical resources and experience necessary to successfully litigate malpractice claims.The Medical Malpractice division of Elk & Elk covers the entire state of Ohio and our attorneys specialize in the areas of HMO Managed Care Negligence and medical malpractice.

Examples of HMO negligence include denying coverage of necessary medical procedures, denying coverage for necessary medication, and having a doctor in its network that is known to be guilty of medical malpractice. Health Maintenance Organizations are managed care organizations that contract with hospitals, doctors and other health care providers to provide medical care to individual members.  HMO's are usually for-profit companies with stockholders to answer to.  Unfortunately, HMO's can be more interested in protecting their interests and not in providing the care of their individual members. 

 

Health Insurance and Medical Insurance News

HMO Managed Care Legal responsibilities

HMOs often have a negative public image due to their restrictive appearance. Whether an HMO can be held responsible for a physician's negligence partially depends on the HMO's screening process. If an HMO only contracts with providers meeting certain quality criteria and advertises this to its members, a court may be more likely to find that the HMO is responsible, just as hospitals can be liable for negligence in selecting physicians. The Employee Retirement Income Security Act (ERISA) can be held to preempt negligence claims as well. In this case, the deciding factor is whether the harm results from the plan's administration or the provider's actions.

HMO Managed Care Legal responsibilities

• Not sanctioning adequate care for the needy
  
• Failure/delay in making referrals to physicians and hospitals outside the HMO network
• Delay in executing care plans
  
• Failure to run diagnostic tests
  
• Failure or delay in treating an emergency condition
• Denying access to other qualified medical practitioners
  
• Failure or delay in transferring a patient to a competent medical provider
  
  

Our medical malpractice attorneys strive to provide our clients with the most effective legal representation possible. Our law firm is dedicated to the rights of medical malpractice and medical mistake injury victims throughout Ohio and for more than 45 years. Elk & Elk has leveled the playing field between medical malpractice victims and the large insurance companies and corporations on the opposing side.
Call us at 1-800-ELK-OHIO for a free evaluation or fill out our free evaluation form.