"Health & Medical News"

Washington — The Pennsylvania House last month adopted a bill that would expand access to health insurance, but physicians have concerns about the measure’s funding and mandate for physicians to participate in its health plans.

The legislation, passed 118-81 on March 17, would provide coverage through state-subsidized private health plans to an estimated 218,000 of the state’s 767,000 uninsured adults by 2012. It would gradually phase out the state’s medical liability program. Democratic House leaders added the health expansion plan, called Pennsylvania Access to Basic Care, or PA ABC, to the liability reform bill.

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Colorado’s noneconomic damage cap in medical liability cases is under fire. Physicians say legislation — approved by the state Senate in late February — threatens to unhinge the state’s stable medical liability climate.

The bill, backed by trial lawyers, would raise the current $300,000 cap by roughly 50%, to more than $460,000, largely to track inflation. More problematic, doctors say, is that injuries classified as physical impairment or disfigurement no longer would be subject to the limit on pain and suffering awards.

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Pennsylvania physicians are fighting to stave off Gov. Edward G. Rendell’s plan to divert funds from the state’s medical liability assistance program to cover the uninsured.

Doctors and other health care professionals contribute annually into the Medical Care Availability and Reduction of Error Fund — known as Mcare — set up under a 2002 tort reform package. Physicians are required to have $1 million in liability insurance, but the fund subsidizes half of their premiums and pays claims exceeding $500,000.

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For the second straight year, medical liability insurance rates are easing nationwide, with nearly 84% of company-reported rates holding steady or dropping in 2007. That’s according to the latest Medical Liability Monitor survey, the largest of its kind to track how much insurance carriers charge physicians.

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Physicians say a series of favorable court rulings is turning the tide in their crusade against frivolous medical liability lawsuits.

Three Ohio courts in six months sanctioned plaintiff lawyers for pursuing unsupported claims against three doctors. Judges awarded the physicians their legal expenses. In New Orleans, the 5th U.S. Circuit Court of Appeals upheld a similar award to a Mississippi doctor Nov. 13.

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Wisconsin physicians are challenging what they call an illegal $200 million plunder of the state’s medical liability compensation fund to balance the state budget and pay for health care initiatives.

The Wisconsin Medical Society sued the state on Oct. 29, just days after Gov. Jim Doyle signed a two-year budget that transfers money from the Injured Patients and Families Compensation Fund to finance Medicaid programs and expand assistance to uninsured families. The state is set to withdraw $71.5 million from the fund in 2007-08 and $128.5 million in 2008-09.

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When Lancaster, Pa., neurosurgeon John A. Gastaldo, MD, saw his medical liability insurance premiums double through his regular carrier, he searched for alternatives. With a limited number of insurers doing business in the state five years ago, options were scarce.

Dr. Gastaldo, though, found a way. In 2003, he and some colleagues in the same predicament decided to self-insure by forming their own risk-retention group: Central Pennsylvania Physicians Risk Retention Group Inc.

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While physicians in some states will see a break in their medical liability premiums next year, Maryland insurance officials are questioning a proposal by the state’s largest medical liability insurance carrier to issue a credit to its physician policyholders on Jan. 1, 2008.

In a Sept. 13 order, Maryland Insurance Commissioner Ralph S. Tyler halted Medical Mutual Liability Insurance Society of Maryland’s plans to pay a portion of a $68.6 million dividend to policyholders as a premium discount. The company allotted some of the money to reimburse the state because it subsidizes Medical Mutual’s premiums under a program set up in 2005 to ensure that doctors have access to medical liability insurance.

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