The Act creates a tort with liability for Health Maintenance Organization (HMO) decisions concerning medical conditions that result in death or injury. A plaintiff may recover actual damages from an HMO or managed care provider if the plaintiff can prove he or she suffered from a poor decision made by an HMO. The Act excludes punitive damages. The purpose of the Act is to provide a remedy for patients whose HMOs refused medical services or denied them timely diagnostic procedures. The Act also creates an independent review panel to review claims before lawsuits proceed.
