Herman Gerel is confronting managed health care organizations in the interest of patient rights.
Originally, HMOs and other managed health care systems were implemented to provide necessary medical attention at a reasonable cost to a wide range of patients. Unfortunately, these health care plans have deteriorated from a productive system where physicians make decisions based on medical necessity, to an industry where the bottom line takes precedence over the patient's welfare. The disturbing reality is that physicians have surrendered their professional judgment to unqualified corporate number-crunchers whose primary focus is on the reduction of costs.
At the same time, managed care companies such as Pharmacy Benefits Managers (or "PBMs") have found ways to divert health care expenditures from patients and providers, while pocketing secret rebates, pricing spreads, and other revenue from drug manufacturers and pharmacies.
The national firm of HERMAN,& GEREL, LLP is the leader of a nation-wide team of firms representing unions, governmental bodies, corporate plan sponsors, and individuals against the PBM industry, in order to recapture the funds which have been wrongfully diverted from patient treatment and care.
While the federal ERISA law has traditionally limited an individual's rights in pursuing claims for MEDICAL MALPRACTICE against HMOs, HH&K and H&G have used ERISA to help individuals obtain coverage which has been denied them, and to seek changes in the system, (when, for example, United HealthCare of Louisiana attempted to kick Children's Hospital out of it's network at the end of the year, after the member renewal period).
Ultimately, the goal of litigation is not to destroy HMOs PBMs, or other managed care organizations, but instead to utilize the legal system to implement a positive and lasting change in the health care industry and to remedy the increasing abuse of both patients' and physicians' rights. In addition to cases involving the denial of medical care, HH&K and H&G are also prosecuting actions involving antitrust issues, illegal subrogation practices, and prescription drug fraud.