A Hawaiʻi circuit court judge issued a ruling this month that many in the health care industry are watching closely. The ruling was against Hawaiʻi’s largest health insurance company, HMSA.
The Big Island attorney who took on the case against the insurer hopes the case could be a game changer when it comes to the contracts between HMSA and doctors and patients.
Attorney Ted Hong says he took several years to carefully craft the lawsuit and was grateful the court issued a decision that went in his favor.
Judge Robert Kim wrote, “The HMSA agreements wrongfully infringe on the practice of medicine between the physician and patient.” Kim called them “unconscionable” and “unenforceable.”
Hong spoke with The Conversation about the case and his client, Dr. Frederick Nitta, a longtime OB-GYN in Hilo. Hong said Nitta is taking it upon himself to challenge HMSA about their business practices, such as denying coverage for medical tests.
In a written statement, HMSA said it disagreed with the court’s decision and has appealed it.
"The order was not a decision on the merits of any party’s claims and is limited to the specific individuals and unique facts in the lawsuit and therefore, it does not impact other HMSA provider or member agreements," HMSA said.
This interview aired on The Conversation on Feb. 22, 2024. The Conversation airs weekdays at 11 a.m. on HPR-1.
