Health Insurance Companies May Find Themselves Policing Doctors and Hospitals
Cleveland, OH (Law Firm Newswire) June 13, 2013 - Nevada’s courts ruled health insurance companies must monitor the practices of health care professional members.
“Nevada just handed down a ruling with the potential for an octopus-like reach ---- a $24 million jury verdict in a hepatitis C outbreak case that indicated health insurance companies are required to watch over the practices of their members,” stated Christopher Mellino, a Cleveland medical malpractice lawyer. “It’s well worth reading: Helen Meyer v. Health Plan of Nevada Inc, Eighth Judicial District Court (Clark County), No. 09A583799; and Bonnie Brunson v. Health Plan of Nevada Inc, Eighth Judicial District Court (Clark County), No. A-10-608344-C.”
Evidently the court found medical professionals related to UnitedHealth Group Inc., accountable for infecting two individuals with liver destroying Hepatitis C. The plaintiffs alleged they were infected due to their doctor using unsafe injection practices during an endoscopy. There were three plaintiffs in the suit, with one being the wife of one of the affected plaintiffs.
“What is unusual about this case is that in medical negligence cases, plaintiffs may only obtain damages from a hospital, doctor or both. In this lawsuit, the argument was made that the UnitedHealth Group should be held accountable, because the doctor was a member of their network and they should have known about his questionable and unsafe practices,” Mellino explained.
If this presumption of liability is upheld on appeal, and brought into play across the nation, it would be a major change for insurance companies. They would find themselves having to police their network physicians, which would likely translate into further restricting what doctor members of the network may do, or raise their malpractice premiums further.
“Even though this particular case was decided based on Nevada’s tort law, other states may take Nevada’s lead and force insurance companies to become Big Brother overseeing member doctors. This would actually bode well for potential victims of medical malpractice, as it would offer them protection in the form of a third party making sure the doctor is doing their job the right way. Given that most medical malpractice victims routinely get the short end of the stick with capped damages, this may be a welcome addition to their arsenal of protection,” suggested Mellino.
Based on evidence that may have been withheld at trial, it appears the doctor may have been a one-off exception in that he hid his actions from everyone, including other health agencies and the federal government. Whether that is the case and that information does come out on appeal, the can of worms that represents medical malpractice accountability and justice for innocent victims has been opened.
Plaintiffs in this case are seeking punitive damages for over $1 million. Since any award would be capped, it may ultimately come out at $240 million. The clock is ticking. If the case is upheld, patient care may take on a new dimension, with insurance companies watching over the physician’s shoulder.
Mellino Robenalt LLC
200 Public Sq., Suite 2900
Cleveland, Ohio 44114
Call: (216) 241-1901
- Nutrition Science Initiative’s Energy Balance Consortium Study Attempts to Identify the True Cause of Obesity
A new non-profit organization, The Nutrition Science Initiative (NuSI), is sponsoring an exciting study on obesity. Called the Energy Balance Consortium, the study could have profound implications for future research into improving the public’s health and overall wellbeing. The prevailing paradigm concerning obesity is that it is caused by consuming too many calories and not burning off enough of them in exchange to keep fat to a minimum. For 60+ years, this “calorie centered” thinking about adiposity has dominated research and treatment approaches. A minor point of view, however, suggests that the quality of calories needs to be considered, instead. […]
- Common Anesthesia Mistakes: An Overview
Due to the development of better sedation drugs and more sophisticated means of patient monitoring, the mortality rate from anesthesia has dropped significantly since it was first declared a public health problem 50 years ago. Anesthesia mistakes still happen, however, affecting the lives of tens of thousands of patients every year. Lapses in Protocol Anesthesiologists must follow a complex routine each time a patient has a sedation procedure. They need to administer not only the proper drug but also the right amount. Monitoring begins the minute a patient enters the hospital, and the anesthesiologist conducts an interview with the patient […]
- Common Causes of Birth Injuries
The last thing any woman thinks about when she is about to give birth is the possibility that her baby will be injured during the hospital delivery process. Yet injuries occur during at least 2 percent of live births each year in the United States, and they can lead to expensive and sometimes life-threatening conditions, including broken bones, permanent nerve damage, emotional and cognitive impairment, and cerebral palsy. Natural Risk Factors for Birth Injury Some conditions increase an infant’s chances of being injured. They are: A birth weight over 8 pounds, 13 ounces. Premature labor. An unusually shaped uterus. Difficult […]