Developments Related to Malpractice in Five States, District of Columbia, Kaiser Daily Health Policy Report Examines

Main Category: Medical Malpractice / Litigation
Article Date: 07 May 2005 - 0:00 PDT

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Kaiser Daily Health Policy Report highlights recent developments related to medical malpractice in five states and the District of Columbia. Summaries appear below.

• District of Columbia: Mayor Anthony Williams (D) on Wednesday introduced the Healthcare Reform Act of 2005, which seeks to reduce the cost of malpractice insurance in city, the AP/Washington Times reports (Westley, AP/Washington Times, 5/5). The bill, submitted to the D.C. Council for consideration, would require patients who seek to file malpractice lawsuits to first obtain a "certificate of merit" from a physician to confirm that the claims have "a reasonable basis." In addition, the legislation would limit the fees that attorneys could collect in malpractice lawsuits to 40% of the first $50,000 in damages awarded and 15% of damages awarded in excess of $600,000. The bill would cap noneconomic damages in malpractice lawsuits against physicians at $250,000. The legislation also would cap noneconomic damages in lawsuits against hospitals at $500,000 per plaintiff and $1 million total. In addition, the bill would allow the D.C. insurance commissioner to require malpractice insurers to provide justification for large premium rate increases and require the city Health Department to develop a system for reporting "adverse medical events." Williams said, "If we're really serious about expanding the provision of health care in this city, we ought to adopt these reforms." However, Wayne Cohen, president of the Trial Lawyers Association of Metropolitan Washington, D.C., called the legislation "an awful bill" for patients that "protects doctors who commit the worst malpractice" (Montgomery, Washington Post, 5/5). D.C. council members said that several committees would have to approve the bill before a vote of the full council (Redding, Washington Times, 5/6).
  


• Illinois: State lawmakers have begun to consider proposals to improve the system used to discipline physicians in the state in an effort to reduce the cost of malpractice insurance, the Chicago Tribune reports. According to National Practitioner Data Bank, 5% of the physicians who have made malpractice payments over the past 15 years account for almost one-third of the increase in malpractice insurance costs over that period. Some physicians maintain "that's evidence of a few disproportionately large jury awards," but others "say it suggests a handful of doctors are causing more than their share of the problem" and state medical boards "aren't doing enough to weed them out," the Tribune reports. Under current Illinois law, the state Department of Financial and Professional Regulation can consider allegations of malpractice for up to five years after the incident occurred, and the department can investigate malpractice lawsuits for one year after they are settled or result in jury verdicts; the department has asked state lawmakers to extend the investigation time to ten years. In addition, the Illinois State Medical Society has asked state lawmakers to increase the number of investigators and to ensure the department has adequate funds. In 2004, 125 of 240 Illinois physicians who were investigated lost their medical licenses or privileges, compared with 29 of 110 physicians in 2000. Illinois currently ranks 25th nationwide for physician discipline, according to a recent study conducted by Public Citizen (Parsons, Chicago Tribune, 5/1). Craig Backs, president of the medical society, said last week, "If (lawmakers) come up with what we feel is truly a meaningful package of reforms, we hope to be able to support something. We are going to be very careful to make sure that it is something meaningful and not just language that sounds good but doesn't really accomplish anything" (Keith, AP/Chicago Sun-Times, 5/2).
  


• Indiana: The Indiana State Medical Association last week said increased malpractice insurance premiums -- in combination with increased operational costs and inadequate Medicaid reimbursements -- could prompt a number of physicians to leave the state, the Evansville Courier Press reports. According to a 2003 telephone survey of Illinois physicians commissioned by the association, one-third of respondents said that they planned to leave the state. Those respondents said that they would move to different states with healthier populations and lower malpractice insurance rates, retire early or leave the profession, the survey found. Kevin Burke, president-elect of the association, said, "We will have big-time access problems if that happens." Association officials said that they delayed the announcement of results of the survey for two years to allow adequate time to evaluate the data (Langhorne, Evansville Courier Press, 4/28).
  


• New Hampshire: The New Hampshire Trial Lawyers Association and the New Hampshire Medical Society have announced their support for legislation (SB 196) that would require the state to hold a public hearing on any request by an insurer to increase or decrease medical malpractice insurance rates by more than 15%, the Nashua Telegraph reports. The requirement would apply to all forms of medical malpractice insurance, including coverage for dentists, nurses and non-surgical specialists. State Sen. Martha Fuller Clark (D) said the legislation would help officials understand how insurers set malpractice rates. David Withers, a property and casualty actuary for the state Insurance Department, said the department supports the bill. He added that some insurers might try to avoid the requirement by enacting frequent but small rate increases. If the bill is approved, it would be the first state law guaranteeing public comment in any line of insurance (Landrigan, Nashua Telegraph, 4/28).
  


• Ohio: The state Medical Malpractice Commission last month issued its final recommendations, saying that Ohio should establish a statewide patient-safety center and create a court dedicated specifically to malpractice lawsuits. The safety center would be a private-government partnership that would coordinate patient-safety efforts, collect information on medical errors and establish a pilot program for the dedicated court. The commission also recommended that the state not change its system for reviewing insurers' rates but should instead establish programs to forgive doctors' educational loans and provide incentives for doctors in high-risk specialties to practice in Ohio. The commission said that a $12 million fund earmarked by the state Legislature last year for new malpractice initiatives should be used for other purposes. The recommendations will be presented to state lawmakers and the governor (Brown, Cleveland Plain Dealer, 4/28).
  


• Pennsylvania: Malpractice insurance costs consume about $3 of every $100 spent on patient care at hospitals in the state, according to a report released May 2 by the Pennsylvania Health Care Cost Containment Council. PHC4 examined malpractice insurance costs at hospitals during 2004 and found that the 182 general acute-care facilities in the state spent $636 million on malpractice insurance. As a percentage of net patient revenue, malpractice expenses averaged 2.67% at hospitals statewide in 2004 but only 1.6% at hospitals in the eight counties in the southwest area of the state. Pittsburgh had the lowest malpractice costs in the state. Philadelphia hospitals spent 3.95% of net patient revenue on malpractice costs. The study also found that in fiscal year 2004, hospitals subsidized the malpractice insurance of 5,289 physicians and other medical personnel at a cost of $37.4 million, or $7,077 per doctor. Marc Volavka, executive director of PHC4, said the report is intended to help provide a baseline for determining future trends in malpractice insurance in the state (Snowbeck, Pittsburgh Post-Gazette, 5/3).
  
  The report is available online. Note: You must have Adobe Acrobat Reader to view the report.

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