Kaiser Daily Health Policy Report Examines Medical Malpractice Developments in Three States, D.C.

• Florida: Health Underwriters Group of Florida, a new not-for-profit malpractice insurer owned by physicians, over the past 16 months has enrolled 500 physicians, some of whom previously had no coverage, the Miami Herald reports. According to the Herald, as many as one-third to half of the physicians in Miami-Dade and Broward counties "go bare," or without malpractice insurance, because of high premium rates. HUG currently offers premium rates similar to those of other malpractice insurers in South Florida but hopes to decrease rates in the future. Family practitioners who receive malpractice insurance through HUG pay about $26,000 in annual premiums, with a $250,000 maximum per case, as well as a one-time payment of $26,000 that they can make over five years. HUG CEO Steven Salman said the organization will not seek profits and will maintain a "very rigorous underwriting process" to help reduce malpractice insurance premium rates. HUG, which sells malpractice insurance policies statewide, also will seek to eliminate "frivolous lawsuits" to help reduce premium rates, Salman said. He added that legislation passed by the state Legislature in 2003 to address malpractice insurance costs has not led to reduced premium rates (Dorschner, Miami Herald, 7/18).
  


• New Hampshire: The two largest malpractice insurers in New Hampshire hold more than 60% of the market, and the eight largest hold more than 82% of the market, according to David Withers, a state property casualty actuary, the Manchester Union Leader reports. Withers, who testified on Monday at a state Department of Insurance hearing, said that malpractice insurance premium rates for the Medical Mutual Insurance Company of Maine increased by 80% between January 1999 and March 2005. Over the same period, malpractice insurance premium rates for the New Hampshire Joint Underwriting Association increased by 30% and premium rates for ProMutual Group ProSelect Insurance increased by 31.1%, Withers said. Hospital administrators and insurance industry consultants also testified at the hearing. According to the Union Leader, the hearing "could be a preliminary step" toward a decision by New Hampshire Insurance Commissioner Roger Sevigny that the malpractice insurance market is noncompetitive, a move that would allow him to "review rates before they are put in place and disapprove rates he finds unreasonable." At the hearing, Sevigny said that Withers had presented evidence of "all of the factors that ... would cause me to declare the market noncompetitive" (Manchester Union Leader, 7/19).
  


• Pennsylvania: One-third of medical residents in high-risk specialties in Pennsylvania said that they plan to practice medicine in a different state because of high malpractice insurance costs, according to a study published last month in Obstetrics and Gynecology, the Pittsburgh Post-Gazette reports. The study, part of a larger project on medical liability in the state launched by the Pew Charitable Trusts, surveyed 68 medical residency program directors and 360 residents near the end of their training. Of medical residency program directors surveyed, 71% reported a decrease in retention since 1999, the study found. The results of the study "suggest this trend bodes ill for a state that already has one of the lowest numbers of doctors under 35 in the country," according to the Post-Gazette. Study co-author Michelle Mello, a professor of health policy and law at Harvard University, said that Pennsylvania might not experience a physician shortage for some time because the state currently has a surplus of physicians in urban areas. However, Mello added that, "if those trends continue, it may be something to worry about" (Shoyeb, Pittsburgh Post-Gazette).
  


• Washington, D.C.: A Washington, D.C., task force that has held meetings since May to discuss proposals to reduce malpractice insurance premium rates for physicians ended discussions on Thursday and will release recommendations next week, the Washington Times reports. The recommendations likely will include a required 90-day notification for malpractice lawsuits and early mandatory mediation before the legal discovery process begins. According to Peter Lavine, chair of the Medical Society of the District of Columbia, the recommendations are "insufficient" compared with a proposal issued earlier this year by Mayor Anthony Williams. The proposal in most cases would cap noneconomic damages in malpractice lawsuits against physicians at $250,000 and would cap noneconomic damages in lawsuits against hospitals at $500,000. The proposal, opposed by the Trial Lawyers Association of Metropolitan Washington, likely will not pass the City Council (Redding, Washington Times, 7/21).