Kaiser Daily Health Policy Report Examines Developments Related to Medical Malpractice Insurance in Six States

The Kaiser Daily Health Policy Report highlights recent developments related to medical malpractice insurance in six states. Summaries of the developments appear below.

• Arkansas: Philip Howard, chair of the Common Good coalition, and Morgan Welch of the Welch and Kitchens law firm on Thursday were scheduled to debate whether special medical courts should be created to rule on medical malpractice cases, the Arkansas Democrat-Gazette reports. Full-time judges would preside over the medical courts, which would only rule on health care claims, and they would have the power to hire neutral experts in various areas of medicine. The courts would not have juries. Before the event, which was sponsored by the Democrat-Gazette, Howard said that the courts would expedite proceedings, allow patients to get their money sooner and lower legal costs. In addition, he said medical courts would "begin to eliminate the paranoia that causes doctors to order unnecessary tests that drive up the cost of health care." However, Welch told the Democrat-Gazette that special medical courts would violate individuals' Seventh Amendment right to a trial by jury. He added, "A special court brings a special empathy and a different bias. The focus swings away from the individual to the industry, and that benefits the industry" (Wickline, Arkansas Democrat-Gazette, 8/12).
  
  
• Connecticut: Trial attorneys and consumer advocates in a letter sent on Wednesday called on state Insurance Commissioner Susan Cogswell to re-examine an approved 89.6% malpractice insurance premium rate increase for Indiana-based GE Medical Protective, which covers 225 physicians in the state, the Hartford Courant reports. The Connecticut Trial Lawyers Association, the Connecticut Healthcare for All Coalition, Connecticut Patients' Rights Group and an OB/GYN in the letter ask Cogswell to issue a cease-and-desist order for the higher rates, which took effect on July 1, and hold a public hearing on the issue. The trial attorneys said that they commissioned an actuarial review of the GE rates and found that the company used faulty claims history data to justify the increase. The letter states, "Given the high level of profits earned by Med Pro, we believe it unconscionable for Med Pro to request an almost doubling of its rates, which will result in even more outrageously high profits at the expense of Connecticut physicians and surgeons." The letter added that the rate increase "could in turn adversely impact the health care available to the citizens of Connecticut." State Insurance Department spokesperson Kate Kiernan-Pagani said that actuaries use different methodologies and assumptions and often reach different conclusions. She added that the department had forwarded the letter to GE and is "taking it seriously. We're doing what we're supposed to do." GE spokesperson John Novaria declined to comment on the letter but said that "everything we're doing is actuarially justified" (Levick, Hartford Courant, 8/12).
  
  
• Maryland: All 100 doctors comprising the general medical staff at Prince George's Hospital Center on Monday voted to ask administrators to allow them to work without malpractice insurance, premiums for which could increase in the state by 40% next year, the Washington Post reports. According to the Post, hospital officials said it was "unlikely they would honor the doctors' request." General surgeons at the state's Shady Grove Adventist Hospital two weeks ago passed a similar resolution to drop their liability coverage and ask administrators to not force them to cover the emergency department. If the doctors are allowed to drop their malpractice insurance, they would not lose their licenses because the state does not require proof of insurance. However, should the doctors drop their insurance, hospitals would have to suspend them or find an alternative way to cover them. Bob Howell, spokesperson for the not-for-profit Dimensions Healthcare System, which runs the Prince George's hospital, said the company "empathize[s] with our doctors" and will try to "figure out how we can help them based on our own situation." Mark Seigel, an OB/GYN at Shady Grove and president of MedChi, the state's medical society, said, "This is a move of desperation. It's really a cry for help. ... This has never happened before." However, Mark Cohen, a medical malpractice attorney in Baltimore, said the doctors would not follow through on their vote because it would cause them to lose hospital privileges and contracts with health care plans. "It's scare tactics. I think what they want to do is generate sympathy, but they will just generate anger," Cohen said (Wiggins, Washington Post, 8/11). Meanwhile, independent presidential candidate Ralph Nader on Monday criticized Maryland Gov. Robert Ehrlich's (R) call to lower rates by capping noneconomic damage awards in malpractice cases. Nader said the state should impose stricter, more transparent policing measures on doctors and make insurance companies justify rate increases. The governor has formed a task force to address the issue and present a "realistic approach" for lawmakers, Ehrlich spokesperson Shareese DeLeaver said (Green, Baltimore Sun, 8/10).
  
  
• North Carolina: Doctors for Medical Liability Reform, a coalition of medical groups, has spent at least $1.5 million in the state to air 30-minute infomercials advocating federal medical malpractice reform, the Raleigh News & Observer reports. The ads, which resumed in July after initially running for five weeks in February and March, feature physicians and patients discussing how large jury awards against doctors have made it "increasingly difficult to practice medicine," the News & Observer reports. The ads are part of a $10 million advertising campaign that began in North Carolina and Washington state and has spread to Georgia and South Carolina. According to Katie Orrico, a spokesperson for the American Association Neurological Surgeons' Political Action Committee -- one of the medical groups in the coalition, the group chooses states based on "where there is a potential Senate race where this might be an issue." The coalition chose North Carolina because in the race to replace Sen. John Edwards (D), Republican Richard Burr "has been a strong advocate of limiting malpractice awards and has received substantial contributions from physicians," whereas his opponent, Democrat Erskine Bowles, has received donations from trial lawyers who oppose such caps, according to the News & Observer. Burr also has agreed to sign the coalition's pledge for congressional candidates that they will support caps on noneconomic damages, but Bowles has not (Christensen, Raleigh News & Observer, 8/6).
  
  
• Oklahoma: In their efforts to recruit volunteer physicians, several free health clinics in the state Oklahoma are planning to inform doctors of tort reform to be implemented Nov. 1 that is designed to protect volunteers from medical malpractice lawsuits, the AP/Richmond Times-Dispatch reports. "I think it will be at the forefront of our recruitment letter," Jana Timberlake, executive director of the Oklahoma County Medical Society, said. The new law recognizes the federal Volunteer Protection Act of 1997 and expands its definition of a free clinic. Under the law, patients and physicians must sign a statement that indicates the physician will not be compensated for treatment and the patient will have a limited ability to sue for damages (Marciszewski, AP/Richmond Times-Dispatch, 8/9).
  
  
• West Virginia: Washington, D.C.-based malpractice insurer NCRIC, which in January announced plans to leave the state in response to a decision by the state Insurance Commission to reject a request for a 35.2% premium rate increase, on Wednesday sent a new rate request to the commission, an indication that the company "might not pull out of the state after all," the Charleston Gazette reports. State Deputy Insurance Commissioner Bill Kenny said he had not reviewed the new request but indicated that NCRIC had asked for a 9.5% rate increase in addition to the 9.8% increase approved in December. NCRIC officials on Tuesday said that they hope "this (new) rate filing will be approved, thereby enabling us to respond to the medical professional liability insurance needs of health care providers in the state." NCRIC officials added that the approval would allow the company to renew malpractice insurance policies for about 100 West Virginia physicians scheduled to expire between Sept. 1 and Dec. 31. Kenny said, "We have to look at it to see if it's actuarially sound," adding, "We think we have a good filing" (Heys, Charleston Gazette, 8/12).