Question

Write a two to three page paper on the legal basis for the immunization of HMOs from being sued for malpractice.

Consider such things as:

• the relationship of the HMO with its member physicians,

• the HMO organizational structure (IPA versus PPO versus staff model and so forth),

• the principle of direct liability, enterprise liability, indemnification, ERISA preemption, ostensible agency, and anything else that you believe would fall under an HMO's vulnerability to being sued.

An historical perspective would enhance the strength of your paper. Remember to cite sources.

Answer 1

Basically legal doctrine provides only licensed physician practice medicine..Managed care organization can not sued medical malpractice, corporation can not practice medicine..In managed care HMOs corporate practice of medicine doctrine will be illegal to practice medicine..HMO taking care of patients but they can not be responsible for medical malpractice..unlike insurance companies under fee-for-service plans..HMOs can involve in .Patients care for their treatment to guide medical specialists..HMOs responsible for high quality care by choosing best doctors and hospitals and monitoring work for highest standard..But HMOs not responsible if any thing happen to Patient due to Physician negligence and malpractice..

Health Maintenance organization participate in public program it focused first in Medicare and Medicaid experience of HMOs..Few HMOs enrolled in public program member most have enrolled a smaller proportion of theses members in their total enrollment..most HMOs withdraw from Medicare risk contracting are individual practice association (IPAs) that pay their Physicians on a fee-for-service basis..This information important for Medicare HMO contracting and monitoring..HMOs and preferred provider organization (PPOs) responsible for most common type of managed care health insurance plans..Managed care plans provide medical services for patient by HMO or PPO..The structure of HMO help for many Patient to deliver health care in ethical manner to the Patient is the staff model..in staff model HMO employs physician to provide health care services.many organization not employed through HMO but they can deliver health care services to the enroll through contractual relationship..There are four major models of HMO called staff model,network models, individual practice association model and group model..

Medical malpractice liability is governed by state law,but Congress has the power..Employment retirement security Act(ERISA) state law claims against a HMO, for failure to meet normal standards of medical care..Direct liability is Tort liability due to negligence and hazardous activities and product liability cases..same way enterprise liability theory of torts when harm occur due to business products, policies court and law hold their business for liable..