Florida Healthcare Law mobile logo

ERISA/HMO Law

ERISA is a federal law that was originally designed to protect people from big insurance companies. However, a very small section of this huge act provides that an individual has the right to file a grievance against their HMO. Another small provision of the law says that ERISA preempts (is chosen over) state law. Some courts have put these two together and concluded that ERISA’s right to file a grievance against an HMO preempts state medical malpractice law.

Florida has specific HMO provisions that can have the effect of protecting HMO’s from some types of lawsuits. In 2003 insurance companies proposed, and the legislature passed, specific provisions that limit the types of HMO claims that may be pursued. But HMOs do not have complete immunity and there are certain circumstance where they can still be held accountable for their actions.