Articles Posted in Medical Malpractice

Justice for Service Members Who Are Victims of Negligence

Our friends at the American Association for Justice (AAJ) are now fighting for the rights of service members who died not in combat, but because of medical negligence. One case in particular that is coming before a House judiciary subcommittee involves the tragic death of Marine Sgt. Carmelo Rodriguez.

Sgt. Rodriguez served his country with honor for nearly a decade including a tour of duty in Iraq. Tragically, he died of medical negligence. His death should not have happened. When Rodriguez enlisted in the U.S. Marine Corps, he received a routine medical exam. Doctors diagnosed a blotch on his buttock as melanoma, but did not inform him of their diagnosis. Over the next eight years, the melanoma continued to grow. During his service in Iraq, Rodriguez had it examined again. This time he was told that it was “just a wart” and that he should have it examined upon his return to the United States. But when he actually got around to doing that, it was too late. Rodriguez died 18 months later from skin cancer, leaving behind his 7-year-old son.
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This is a victory for patients and California consumers. I’m talking about the California Supreme Court’s decision, which firmly establishes that emergency room physicians may not go after patients to collect any remaining balance remaining after being paid for their services by the patient’s HMO. Before the court’s decision ER physicians had this practice of hounding patients to pay additional bills for emergency services, often sending collection agencies after them. Our source for this blog was this news report in the San Francisco Business Times.

How big is this problem? A 2007 study by the California Association of Health Plans, an HMO industry group, reports that more than 1.8 million insured Californians who visited emergency rooms between 2005 and 2007, received bills on top of their copayments and deductibles. The average bill was $300, translating to an overall tab (for that two-year period) of $528 million.

State law requires that ER physicians perform emergency services to stabilize a patient. If the patient has HMO, then the HMO is required to pay for such emergency care. The problem, however, is that in emergency situations, HMOs may not have had a prior contract with the physician who is performing that service. So there has been increasing friction between the HMOs and emergency physicians about the discrepancy between what the HMOs will pay and what the physician has billed or will accept. This situation has forced many ER physicians to bill patients directly for the balance.
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