Physicians win one in Illinois high court
Physicians win one in Illinois high court
Plans have to reveal financial arrangements
In a major win for doctors with managed care contracts, the Illinois Supreme Court has ruled that patients suing physicians for negligence can’t also sue them for not revealing payment arrangements with managed care companies. (Therese Neade v. Steven Portes, MD, and Primary Care Family Center, SC).
Rather, it is the plan’s responsibility to inform its customers of any financial arrangements with physicians.
The ruling is important for physician practices because if the Supreme Court had let a lower court’s decision stand it would have opened the door to more lawsuits based on the physician’s failure to disclose financial incentives, even without negligence or malpractice claim. Also, in cases involving malpractice or negligence claims, juries can be influenced by the financial motivation factor when considering damage awards, say legal experts.
"Had the court gone the other way, it would have been chaos for physicians," says LeRoy Sprang, MD, president of the Illinois State Medical Society. "Patients need to understand what the plan offers. But it’s the responsibility of the plan to explain that before a patient signs up so they can make informed decisions when they are buying the plan."
In a friend-of-the-court brief, the American Medical Association (AMA) argued that disclosure of any financial arrangements to patients should come from their managed care organizations. To place that burden on physicians, who are already required to meet all applicable standards of professional care, would be too onerous, it reasoned.
"Physicians already have an ethical obligation to do what is in the best interest of the patient," observes AMA Trustee Donald J. Palmisano, MD. "If someone didn’t do that, the law is clearly about making sure physicians meet that standard under malpractice law."
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