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GOVERNMENT

Miss. doctors hope tort reform brings rate relief -- eventually

Physicians expect the new law to improve the liability climate. Meanwhile, Pennsylvania took another step to strengthen tort laws and other states plan to follow.

By Tanya Albert, amednews staff. Oct. 28, 2002.

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Mississippi has joined the growing number of states addressing physicians' medical liability insurance concerns through tort reform. And physician groups are planning advocacy efforts that could push the issue into the spotlight in other state legislatures next year.

Doctors in Mississippi say they know that the law, passed earlier this month, won't give them immediate relief from high liability insurance bills or the challenge of finding a company to write a policy. But, they say, it gives them hope for a better liability insurance climate in the future.

Mississippi is one of 12 states that the AMA identified this year as being in the midst of a medical liability crisis that has physicians leaving the state, retiring early or refusing to provide high-risk procedures. It joins Nevada and Pennsylvania in passing tort reform this year.

"It shows that the state Legislature has listened to the physicians," said Mississippi State Medical Assn. President John Cook, MD. "The message to physicians in training in Mississippi should be that the state will be a good place to stay and practice. And to physicians looking to relocate here, the message is that it will be a more comfortable place to practice."

The law caps noneconomic damages in medical malpractice cases at $500,000 for the next eight years. That limit is set to rise to $750,000 in 2011 and then to $1 million in 2017. But with eight years and three elections before the cap rises, physicians hope they will be able to hold it at $500,000.

Scheduled to take effect Jan. 1, 2003, the law also holds physicians responsible only for their portion of the noneconomic damages, requires an attorney to find a medical expert before the suit is filed and makes plaintiffs file lawsuits in the county where the alleged malpractice occurred. Legislators hope to address the problem of "jury shopping," in which plaintiffs attempt to have their cases tried in a county where juries traditionally are generous with awards.

Mississippi, Nevada and Pennsylvania passed tort reform measures in 2002; 6 more states expect to in 2003.

The law also prevents physicians from being sued for prescribing a Food and Drug Administration-approved medication. Numerous Mississippi physicians have been named in lawsuits against drug manufacturers so that the cases could be tried in state court, rather than federal court.

Clarksdale, Miss., obstetrician-gynecologist Bo Marley, MD, said those measures will help create a more stable market in the future. But they won't change his premiums now.

"It's still iffy for the next two to three years," he said. "It puts a stop on the lawsuits at a certain point, but we're not out of the woods yet."

The law is likely to face a court challenge over its constitutionality. "The immediate impact of the law will be marginal," said MSMA Past President Hugh Gamble, MD, a thoracic surgeon in Greenville. "Mississippi's problem is that most of the insurance carriers left. They won't come back until the law stands judicial muster."

But David Baria, the Mississippi Trial Lawyers Assn.'s president, said even if the law were to stand up in court, physicians won't see insurance affordability and availability problems go away. He said he was disappointed that physicians did not work on creating a state insurance risk pool, which he said would have done more to solve the current problems.

"It's unfortunate that our Legislature bent to the extreme political pressure," Baria said. "The doctors presented absolutely no facts that a cap will affect rates."

The law hurts patients harmed the most because it limits noneconomic damages, he said. "It does nothing to stop frivolous lawsuits."

Tort reform battles elsewhere

Mississippi was not the only state to pass a tort reform law this month. Pennsylvania also acted against jury shopping by approving a law requiring plaintiffs to file in the county where the alleged malpractice occurred. The new measure builds upon tort reform Pennsylvania lawmakers adopted earlier this year.

"This is another step toward reform," said Chuck Moran, Pennsylvania Medical Society spokesman. "But it is certainly not the end. Ultimately, we want a cap on pain and suffering."

Mississippi is among 12 states identified as being in a liability crisis.

Pennsylvania physicians will not be alone in their fight. About a half dozen state medical societies are gearing up to push tort reform in their state legislatures next year.

The Minnesota Medical Assn.'s House of Delegates passed a resolution calling for the state's Legislature to enact a $250,000 cap on noneconomic damages, a sliding scale for attorney fees and a standard of "clear and convincing" evidence to prove punitive damages. Lawmakers go back into session in January 2003.

Medical societies in Florida, Kentucky, Texas and West Virginia also are deciding which reforms they will try to push through their state legislatures next year. Caps on noneconomic damages are a top priority.

"We cannot let this Legislature adjourn without meaningful reform," said Kim Ross, Texas Medical Assn. vice president for public policy.

And at the national level, physicians continue to push a package that would place a $250,000 cap on noneconomic damages. The U.S. House of Representatives passed the bill in September. A companion measure has been introduced in the Senate but has not been discussed yet. Political experts say the Senate is unlikely to consider the bill before year's end.

"It is very important for all physicians to work at two levels to solve the medical liability crisis -- the state level and the federal level," said Donald J. Palmisano, MD, AMA president-elect. "Those states with laws need to protect their laws. The states without medical liability reform need to work aggressively to achieve it."

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 ADDITIONAL INFORMATION: 

States take action

Tort reform adopted this year:

Pennsylvania

  • Allows malpractice damages to be paid over time.
  • Sets higher expert witness standards.
  • Creates a patient safety authority.
  • Phases out a jury award pool into which doctors must pay.
  • Establishes a 7-year statute of limitations in most cases.
  • Requires plaintiffs to file in the county where the alleged malpractice occurred.

Nevada

  • Sets a $350,000 cap on noneconomic damages in most cases and a $50,000 limit on damages for hospitals and physicians treating trauma patients.
  • Holds doctors financially liable only for the damages for which they are responsible.
  • Allows judgments to be paid over time.

Mississippi

  • Caps noneconomic damages at $500,000 until 2011. The cap then goes to $750,000 until 2017 and $1 million after that.
  • Holds physicians responsible only for their portion of the noneconomic damages.
  • Requires lawsuits to be filed in the county where the alleged malpractice occurred and ensures that lawyers notify physicians at least 60 days before a lawsuit is filed.

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Copyright 2002 American Medical Association. All rights reserved.
 
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