In a win for physicians in their struggle with managed care, a divided California Supreme Court has ruled that HMOs and related health insurers must, under certain circumstances, give physicians they dismiss a reason for the action and a chance to appeal.
“This is a tremendous victory in that fair hearings provide fundamental protections against wrongful restrictions that disrupt patient care,” commented Astrid Meghrigian, a San Francisco lawyer with the California Medical Association. The CMA and the American Medical Association were lined up against such organizations as the California Association of Health Plans as amicus curiae in the closely watched case.
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