HMO Misconduct Lawyer

Often, HMO members do not have a choice in who is providing their care and they must demand crucial tests and treatments. As HMOs work to keep costs down, patient care may be compromised. HMOs often offer incentives for physicians to keep costs down, resulting in the failure to perform critical treatments because they are costly. Actions for malpractice against HMOs can arise when the HMO delays or denies critical tests, delays or denies particular treatment, or delays or denies referring someone who needs care to a specialist. In addition to delay other potential causes of action may arise if your treatment ended sooner than it should have or if you only received partial treatment.

In some states, HMOs cannot be held liable because of a held liable because of a federal law called the Employee Retirement Income Security Act. This law preempts some state regulations. In Illinois however, HMOs can be liable for medical practice for delay or failure for treatment or other types of misconduct. Although Illinois law allows HMOs to be held liable for misconduct and be sued for malpractice, HMOs may include mandatory arbitration provisions in the contracts they have members sign, which adds a difficult legal challenge that should only be faced with the help of an experienced lawyer.