Physicians win lawsuits over inadequate PMPM rates.
When capitated doctors are sued for non-referral to specialists, typical charges include that the capped network's PMPM rates served as a disincentive to refer. So far none of the charges have prevailed. Physicians also are winning lawsuits alleging inadequate capitation rates from HMOs.
D002204:Capitation Fee / Q000331:legislation & jurisprudence*; D006279:Health Maintenance Organizations / Q000191:economics / Q000331:legislation & jurisprudence*; D006801:Humans; D007193:Independent Practice Associations / Q000191:economics / Q000331:legislation & jurisprudence*; D016365:Liability, Legal; D010820:Physicians / Q000191:economics / Q000331:legislation & jurisprudence*; D012017:Referral and Consultation / Q000331:legislation & jurisprudence*; D014481:United States