Even if that is proven, ERISA limits damages… [ensuring] the HMO will not be punished" in a substantive fashion (ERISA, 2004, HARP).
However, some state courts, despite ERISA have held HMOs directly liable for negligent treatment of their members, such as when an HMO refused to grant a patient the 30 days of inpatient psychiatric care his doctor said he required and only covered 10 days. The California court "ruled that an organization, such as the patient's HMO, that substantially shaped the course of patient care could be held liable for the quality of the care actually delivered… a Pennsylvania court also held that an HMO could be held liable for injuries to its members as a result of its hiring incompetent physicians" (HMO malpractice, 2009, Mega Justice). In these instances, the HMO was held directly responsible for denying coverage or the actions of member physicians.
Some have also suggested that being able to sue HMOs under the concept of enterprise liability would be helpful in curtailing costs: "Under the enterprise liability theory, responsibility and liability for medical malpractice shifts from the individual physician to the health maintenance organization (HMO) and effectively provides immunity to individual physicians from medical malpractice actions"(Leone 1993). These would consolidate lawsuits against physicians and also hold HMOs accountable for their action as the ostensible or de facto agency making the decisions for a patient's healthcare. While greater liability would act as an incentive for HMOs...
(Chizek, 2003) The Role legal nurse consultant may provide service in a number of roles, including but not limited to: Consulting expert Testifying expert Facility-based investigator Trainer and in-service presenter Peer reviewer Quality improvement, risk management, claims management Liability insurance marketer and clinical resource" (Chizek, 2003) As standards of care constantly change, medical and nursing staff must keep informed of current standard to develop and/or modify policies and procedures, which must be maintained and secured indefinitely. In the
Euthanasia Should Be Illegal Euthanasia is the act of putting to death painlessly or allowing death, as by withholding extreme medical measures, a person or animal suffering from an incurable, often painful, disease or condition (Euthanasia, Infoplease.com). Today, medical advances have made it possible to prolong life in patients with no hope of recovery, and the term negative euthanasia has arisen to classify the practice of withholding or withdrawing extraordinary
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Medicare and Medicaid Services (CMS), previously the Health Care Financing Administration (HCFA), that by the time 2011, health care expenditure will arrive at $2.8 trillion, as well as it will bill for 17% of the Gross Domestic Product. As a result, it is no revelation that white-collar offenders observe health care deception as a rewarding effort. Certainly, the General Accounting Office ("GAO") quotes that such deception accounts for up
goal of their ethical calling, physicians, nurses and other health care workers are obliged to treat the sick and potentially infectious patients and, in so doing, they are to take some personal risk (Murray 2003). This was the bottom line of the assessment and stand made by Dr. Henry Masur and his colleagues at the National Institute of Allergy and Infectious Disease (NIAID), particularly during the outbreak of dread
In fact, hospitals and nursing homes have the option of advising their patients of their right to either accept or refuse medical treatment and their right to formulate advance directives regarding their care should they become incompetent based internally generated mandates. Conclusion After lengthy debates in 1965, the United States Congress finally passed legislation that established the Medicare program as title XVIII of the Social Security Act. However, based on the
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