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The Illinois Supreme Court has allowed a suit against a descendant's HMO for the actions of its physicians. Petrovich v. Share Health Plan of Illinois, No. 85726 (Ill. Sept 30). The plaintiffs allege that the descendent died of cancer because the disease was not promptly diagnosed by her HMO physicians- in part because the HMO refused to cover diagnostic tests that had been recommended by an in-network specialist. The court noted, " Where an HMO effectively controls a physician's exercise of medical judgement and that judgement is exercised negligently the HMO cannot be allowed to claim that the physician is solely responsible for harm that results."
Although the HMO involved in the case, along with the Illinois Associations of HMOs, reserved judgement on the decision, the Illinois State Medical Society called it a victory. Dr. Clair Callan, president of the society, told the press. "This important opinion gives the patients the right to hold their HMOs accountable for the decisions made affecting their health care."
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