Rush Prudential HMO, Inc.
Petitioner
John G. Roberts, Jr., Counsel of RecordIn 1995, Debra C. Moran began experiencing pain, numbness, loss of function, and decreased mobility in her right shoulder. She sought treatment from her physician, who was affiliated with Rush Prudential Health Maintenance Organization (HMO), Inc., the HMO she and her husband belonged to through his employer. While undergoing treatment recommended by her HMO-affiliated physician, Moran consulted an outside doctor, who recommended a different surgical procedure. Moran asked her physician to request that Rush cover the procedure, but the HMO determined that other forms of treatment were preferable and declined the request. Moran appealed…
