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Supreme Court Deals Blow to Malpractice Plaintiffs

By Janice G. Inman
June 28, 2004

In a disappointing decision for malpractice plaintiffs and their medical caregivers, the U.S. Supreme Court ruled on June 21 that patients do not have a state law private right of action against their Health Maintenance Organizations (HMOs) when such entities make coverage decisions that impact the patient's health care. The decision means patients have little recourse against their HMOs, which under federal law are liable to plan beneficiaries only for the cost of services they wouldn't cover.

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