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Health Plans Face Possibility Of More Lawsuits

Agency for Health Care Administration

Despite objections from the managed-care industry, a Senate committee Tuesday approved a bill that could open HMOs to more lawsuits by patients.

The Senate Banking and Insurance Committee voted 6-3 to approve the bill (SB 262), filed by Sen. Greg Steube, R-Sarasota. The bill, for example, would open HMOs to allegations of what is known as "vicarious liability" when doctors or other health-providers act negligently.

Insurance-industry lobbyists argued that such changes would lead to increased insurance premiums and increased costs for the state in the Medicaid managed-care system.

"Ultimately, you're just raising the cost of health care again in the state of Florida to where it becomes unbearable, and that will be borne by our employers and our employees," said Wences Troncoso, vice president and general counsel of the Florida Association of Health Plans. But Ted Leopold, a plaintiffs' attorney from Palm Beach County, told the committee that HMOs play a major role in making decisions about patient care and treatment.

"No doctor today can make medically necessary decisions without first picking up a phone and saying, 'I want a blood test for my patient. I think he or she has cancer. I want a cardiology test to be done for my patient. I think he has a heart that is failing,' " Leopold said. "They can no longer make those decisions. Those decisions are made by an HMO."