Landmark Ruling Empowers Hawaii Doctors to Make Independent Medical Decisions, Puts Patients First

HONOLULU, Hawaii – A recent court ruling against Hawaii’s largest health insurer, Hawaii Medical Services Association (HMSA), has the potential to grant more autonomy to doctors in the state when it comes to making medical decisions. The ruling, delivered by a judge in Big Island, deemed HMSA’s contracts with its doctors as “unconscionable” and unenforceable. While HMSA is currently appealing the decision, this rare legal victory is being celebrated by doctors and families who have often faced denials of necessary care from the insurer.

One such family is that of Scott Norton, a Big Island contractor who would have turned 62 this month. Norton’s widow, Charlotte Husen, and son, Thor, believed that if HMSA had approved an MRI for Norton’s back pain two years ago, his suffering could have been mitigated. Unfortunately, HMSA required Norton to undergo weeks of physical therapy before authorizing the MRI or specialist care, resulting in his condition worsening. Tragically, it was during this time that Norton’s undetected prostate cancer was ravaging his bones.

Norton’s case is not an isolated incident and prompted a lawsuit against HMSA, which Norton himself joined before his passing in November of last year. Dr. Frederick Nitta, a Hilo OB-GYN and one of the key proponents of the lawsuit, has been battling HMSA for years, aiming to challenge the contracts that dictate the insurer’s payment practices to medical providers. Together with attorney Ted Hong, Nitta gathered the stories of over 30 patients who claimed they were denied necessary care due to HMSA’s preauthorization process.

While HMSA attempted to have the lawsuit dismissed and referred to arbitration, the ruling by Judge Robert D.S. Kim firmly supported the doctors and patients involved in the case. Judge Kim stated that the HMSA agreements unjustly impede the practice of medicine between physicians and patients. Moreover, the judge found that HMSA had capitalized on its market dominance to coerce doctors into signing unfair contracts, further characterizing these agreements as “unconscionable” and unenforceable.

Though this ruling is not final, Nitta hopes that it will embolden more doctors to speak out against HMSA. He emphasized the importance of restoring decision-making power in healthcare to where it belongs – between the physician and patient. HMSA, on the other hand, maintains that this is only a preliminary ruling and has appealed the decision. However, for families like Norton’s, this ruling signifies a step towards healing and accountability from a corporation that many have placed their trust in.

In the pursuit of justice, it is crucial that doctors are able to advocate for their patients without fear of retribution. This ruling has shed light on the struggles faced by doctors who have been silenced by the dominating force of insurance companies. By highlighting the stories of those affected, this lawsuit has sparked a vital conversation about the need for fair and ethical practices within the healthcare industry. As the legal proceedings continue, the hope remains that doctors will gain the freedom to provide the best possible care for their patients, unencumbered by the restrictive policies of insurers like HMSA.