Category Archives: Iowa

May 2017 Newsletter

  Liability reform cited as major savings in President’s budget With an emphasis on deficit reduction, the President’s 2018 budget highlighted how medical liability reform can lead to improved fiscal health. Cited as resulting in major savings and reform, medical liability reform is noted in the President’s budget as necessary due to the fact that “the current medical liability system does not work for patients or providers, nor does it provide quality, evidence-based care,” budget language states. The liability reform proposal in the budget contains proven state reforms that have lowered costs and increased access to care in states such as California, Texas, West Virginia, and Ohio. This allows for deficit reductions of $55 billion over 10 years upon passage of a bill that contains reasonable limits on non-economic damages of $250,000 (increasing with inflation), a three-year statute of limitations, and modifications on attorney’s fees to ensure deserving patients – not personal injury lawyers – benefit from liability judgments and settlements. To review the medical liability reform proposal contained within the President’s budget, click here. Panel discussion yields insights into future of liability reform Taking part in a legal panel on the future of medical liability reform, HCLA chair Mike…

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Liability Reform Brings Help to the Hawkeye State

Friday morning, Governor Branstad signed SF 465 — the IMS-crafted tort reform legislation. This legislation marks the culmination of decades of work by countless physicians throughout our state. “Today’s historic achievement is a victory for every physician, resident, and medical student in the state of Iowa. This success would not have been possible without the tireless work of so many individuals to give the house of medicine a strong voice in the legislative process. I am delighted to begin my tenure as President of the Iowa Medical Society with enactment of these sweeping reforms.” said newly-installed IMS President Joyce Vista-Wayne, MD, DFAPA. SF 465, which will take effect July 1, 2017, enacts the following reforms: A $250,000 Cap on Noneconomic Damages, With Some Exceptions Strengthened Expert Witness Standards A Certificate of Merit in all Medical Liability Suits Expanded Candor Protections A Brief History of These Reforms in Iowa Cap on Noneconomic Damages In 1975, California became the first state in the nation to enact a $250,000 cap on noneconomic damages. Shortly thereafter, IMS made its first attempt at enacting a similar cap here in Iowa. After nearly three decades of work, IMS championed the passage of a $250,000 cap on…

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April 2017 Newsletter

  Medical liability reform – an issue of Price With Tom Price at the helm of the Department of Health and Human Services, and Congress likely to make systematic health care changes, chances for medical liability reform are stronger than ever.  So say several experts in the field. Writing in the New England Journal of Medicine, noted medical liability system scholars Michelle M. Mello, J.D., Ph.D., Allen Kachalia, M.D., J.D., and David M. Studdert, LL.B., Sc.D convey their opinions on the opportunities that lie ahead for proponents of medical liability reform with Secretary Price as an advocate. Citing medical liability in his confirmation hearings, as “a really difficult challenge,” Secretary Price has long been a champion of reforms that reduce medical lawsuit abuse. Acknowledging that “the liability system has well-documented problems, and its reform was omitted from the Affordable Care Act,” the authors support a way forward in the near term. While the current liability system is no longer at the precipice of crisis, Mello, Kachalia, and Studdert agree that “a period of calm in liability insurance markets is the best time to proceed with sensible reform.” The deck is stacked in support of reasonable limits on non-economic damages, with…

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Pushing Back on Medical Liability Misconceptions – NYT Letter to the Editor

To the Editor Re G.O.P. Bill Would Make Medical Malpractice Suits Harder to Win (April 15): In 40 years of practicing medicine, I’ve witnessed a change in physician culture. Physicians no longer rely on clinical judgement based on training, experience and the best available evidence. The fear of lawsuits drives providers to adapt behaviors that lead to increased health-care costs. More than 90% of physicians engage in defensive medicine by practicing assurance behavior; ordering tests, particularly imaging tests, performing diagnostic procedures and referring patients for consultation. These behaviors have become standard of care. Patients also become educated through the internet and media to this new standard and change their expectations of their care perpetuating this expensive cycle. The current” patchwork quilt” medical liability system neither effectively compensates persons injured from medical negligence nor encourages the addressing system errors to improve patient safety. The Protecting Access to Care Act pending in Congress would address these inefficiencies. Most importantly, passing these sensible reforms represents a critical first step in restoring the appropriate practice of medicine where physicians make decisions based only on the patients well being. Stuart L. Weinstein, MD Iowa City, Iowa

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March 2017 Newsletter

  New Congress makes early efforts in support of medical liability reform Just over a month after a new Congress and President were in position, medical liability reform appeared at the top of their agenda as two comprehensive bills were introduced. In late February, the House Judiciary Committee approved the Protecting Access to Care Act, a comprehensive medical liability reform bill introduced by Representative Steve King (R-IA). The Protecting Access to Care Act, H.R. 1215, is modeled after proven reforms already in place in Texas, California, and many other states around the country that have had a positive effect on increasing patient access to care and keeping health care costs affordable for patients and physicians. More recently introduced is the ACCESS (Accessible Care by Curbing Excessive lawSuitS) Act, H.R. 1704, which adds to the gaining momentum for liability reform in the House. President Trump has also expressed his support for medical liability reforms in his address to a Joint Session of Congress. “…We should implement legal reforms that protect patients and doctors from unnecessary costs that drive up the price of insurance,” President Trump stated. “The HCLA is pleased that the House of Representatives and President Trump recognize the need…

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Iowa Senate Advances Bill To Discourage Med Mal Suits

The Iowa Senate on Monday approved a tort reform bill that would cap noneconomic damages in medical malpractice cases at $250,000 and require injured patients to obtain a “certificate of merit” from a medical expert before filing suit. S.F. 465 passed the Iowa Legislature’s upper house in a 28-21 vote that was split along party lines, with 28 Republicans voting to approve the proposed legislation and 20 Democrats and one independent senator voting no. If approved, the bill would impose a $250,000 cap on noneconomic damages such as pain and suffering, similar to a federal bill recently floated by Republicans in Congress. In addition, the bill would require medical malpractice plaintiffs to file a certificate of merit — essentially an expert opinion vouching for the validity of the claims — which is designed to weed out and discourage frivolous lawsuits. The bill would also make certain statements made by doctors to patients regarding adverse medical incidents inadmissible in court, and would tighten the requirements as to who can qualify as an expert medical witness. During floor debate on Monday, a Republican proponent of the bill, state Sen. Charles Schneider of West Des Moines, said that the proposed legislation would help…

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February 2017 Newsletter

  Act NOW for Medical Liability Reform – New Federal Bill Introduced Our grassroots network has been activated to generate support for the Protecting Access to Care Act (H.R. 1215), a new federal bill introduced last Friday that is based on proven state medical liability reforms and which will tackle health care costs that are rising as a result of a broken system. The Protecting Access to Care Act, introduced by Rep. Steve King (R-IA), includes well-known, traditional reforms that ensure full and unlimited recovery of economic damages, allowing for payment of past and future medical expenses, lost wages, rehabilitation costs, and other out of pocket expenses.  The legislation also permits the additional recovery of up to $250,000 for non-economic damages, such as damages awarded for pain and suffering. The bill will be considered by the House Judiciary Committee TOMORROW (Tuesday). Click here to get contact information for committee members and express your support of this critical legislation. The Protecting Access to Care Act also includes a reasonable statute of limitations for filing lawsuits and limits attorney fees, allowing for speedier resolution of claims, and ensuring that damage awards go to deserving patients – not personal injury lawyers. It also…

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Tort Reform Introduced in Iowa Legislature

On Monday, both the House and Senate Judiciary Committees introduced bills on tort reform HSB 105  and SSB 1087  This IMS-crafted tort reform package represents the most comprehensive reforms to Iowa’s medical liability system in more than a generation and marks the culmination of years of work by numerous physician leaders throughout our state. Watch for updates in the IMS Advocate. The bill would enact the following: $250,000 Cap on Noneconomic Damages Strengthened Expert Witness Standards Certificate of Merit in All Suits Affirmative Defense for Evidence-Based Medicine Limiting Contingency Fee Arrangements Expanding Candor A Brief History of Tort Reform in Iowa In 2004, IMS championed the passage of a $250,000 cap on non-economic damages, which was ultimately vetoed by then-Governor Vilsack. In the wake of this setback, IMS redoubled its efforts, devoting significant time and resources into developing additional reform proposals to help improve our liability climate. In 2011, IMS-crafted Certificate of Merit legislation passed the Iowa House but failed to pass the Democratically-controlled Iowa Senate. 2013 also saw significant House action on an IMS-crafted tort reform package that included a $250,000 cap on noneconomic damages and a Certificate of Merit requirement. After the legislature again failed to enact meaningful reforms that…

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An Optimal Outcome for Iowa Candor Legislation

The medical community and attorneys came together in Iowa for a rare partnership that led to an optimal outcome for patients across the state. Signed into law by Governor Branstad, the Communication and Optimal Resolution (Candor) legislation was modeled on successful programs in Michigan, Massachusetts, and other states that have chosen this path when results of medical procedures differ from the intended outcome. The bill passed in Iowa establishes an alternative way to settle adverse medical outcomes that allows patients and physicians to have open and honest discussions – but with an avenue to go through the court system at any time. These alternatives allow deserving patients to be compensated in a timely manner and give physicians closure on difficult and unexpected cases. The Candor bill was the culmination of three years of work between the Iowa Medical Society and the Iowa Association of Justice – with success achieved on improving the state’s medical liability reform for the first time since 2006. To read the Candor bill in full, click here.

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Branstad keeps his address quiet, serious

It was a mostly silent Legislature that took in Gov. Terry Branstad’s annual Condition of the State address Tuesday. Applause lines in the roughly 30-minute speech were rare, and lawmakers mostly ignored the cues to clap. That doesn’t necessarily mean legislators were dismissive of what they heard. Republican leaders were appreciative of the focus on tax relief and job creation, even if they don’t entirely agree on how to deliver it. Democrats, while wary of the governor’s spending plans, praised his remarks about helping to train more Iowans in the skills needed in the workforce. Branstad kept his remarks very focused on a narrow list of priorities. There was very little red meat — and not much poultry, for that matter. He skipped the rhetorical baloney, too, except for a repeated refrain about the days of opportunity facing the state. He reserved most of the public gallery space for his own guests, but mentioned only a few people by name. There was no talk of public safety, gun violence or social issues like gay marriage and abortion. He laid out his priorities for property tax reform, but made no mention of income tax cuts. He also omitted mention of a…

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