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PITTSBURGH -- A Pennsylvania appellate court decision opens the door for malpractice suits against health maintenance organizations in that state.

The decision earlier this month in Shannon vs. HealthAmerica of Pennsylvania Inc. makes Pennsylvania the third state to permit such suits. Texas and Missouri recently adopted laws allowing HMO negligence suits.

"The Superior Court recognized that HMOs are not mere indemnity companies," and that "HMOs are delivering health care and should be subject to the same standards as other health care providers," said plaintiff's attorney Harry Cohen of Harry Cohen & Associates in Pittsburgh.

Mr. Cohen filed the suit in 1994 on behalf of a Butler County, Pa., couple who alleged that HealthAmerica was responsible for the premature birth and subsequent death of their child in 1992.

The decision overturns a 1996 trial court ruling dismissing the suit, which had also named the treating obstetrician. The doctor settled before the trial for an undisclosed sum, Mr. Cohen said.

No HealthAmerica spokesperson could be reached for comment.