Physicians win lawsuits over inadequate PMPM rates

When capitated doctors are sued for non-referral to specialists, typical charges include that the capped network's PMPM rates served as a disincentive to refer. So far none of the charges have prevailed. Physicians also are winning lawsuits alleging inadequate capitation rates from HMOs.

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Bibliographic Details
Published inCapitation management report Vol. 11; no. 1; p. 9
Format Journal Article
LanguageEnglish
Published United States 01.01.2004
Subjects
Capitation Fee - legislation & jurisprudence
Health Maintenance Organizations - economics
Health Maintenance Organizations - legislation & jurisprudence
Humans
Independent Practice Associations - economics
Independent Practice Associations - legislation & jurisprudence
Liability, Legal
Physicians - economics
Physicians - legislation & jurisprudence
Referral and Consultation - legislation & jurisprudence
United States
United States
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Summary:When capitated doctors are sued for non-referral to specialists, typical charges include that the capped network's PMPM rates served as a disincentive to refer. So far none of the charges have prevailed. Physicians also are winning lawsuits alleging inadequate capitation rates from HMOs.
ISSN:1083-7183