Category Archives: Iowa

March 2020 Newsletter

In this time of uncertainty and rapidly changing developments regarding the COVID-19 pandemic, we express our thanks and appreciation for those who continue to work at the front line of our health care systems. The HCLA and Protect Patients Now remain committed to keeping you updated on medical liability reform developments at the state and federal levels. Good Samaritan language added to economic stimulus bill Exemplifying the risk physicians face when working across state lines in a time of crisis is the current need for interstate health care resources to adequately respond to COVID-19 cases while ensuring medical liability coverage. As a result, the Health Coalition on Liability and Access, its member organizations, and congressional cosponsors of the Good Samaritan Health Professionals Act (H.R. 6283/S. 1350) advocated for provisions of this legislation to be included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748) signed into law by President Trump on March 27. While the COVID-19 economic stimulus bill does not include the Good Samaritan language in full, it effectively applies the protections — for which the HCLA has long advocated — to volunteers serving existing or potential COVID-19 patients for the duration of this public health…

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February 2020 Newsletter

The year ahead for patients and physicians Advocating for physicians in over 60 active lawsuits, the Litigation Center of the American Medical Association and State Medical Societies has a busy year ahead in support of access to care. Brian D. Vandenberg, senior vice president and general counsel at the American Medical Association (AMA), recently outlined the priorities for 2020 in an interview with American Medical News. On the docket for the AMA is the rise in hybrid medical liability lawsuits. Vandenberg explains, “Hybrid liability suits attempt to disregard medical malpractice liability caps by conflating distinct legal theories—an end-run around legislative tort reform.” Vandenberg highlights these attempts as “disingenuous” ways to overcome limits on noneconomic damages. “We’ll continue to advocate for meaningful tort reform, and will continue to challenge and file amicus briefs in abusive hybrid lawsuits.” He also emphasized the importance of protecting the patient-physician relationship and the continued ability for open and honest discussions about health care recommendations. When asked about what was at stake in several of their key legal priorities in 2020, Vandenberg answered, “Access and trust. It’s really that simple.” To read the full interview on how the Litigation Center is playing a role in support of ensuring…

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Senators advance $250K cap in medical malpractice cases

SOURCE: Knoxville Journal Express Representatives of Iowa’s medical community blamed soaring awards in medical malpractice cases for the erosion of health-care access in rural Iowa Monday. They were arguing for legislation to put a $250,000 cap on noneconomic damages in lawsuits that arise from medical errors. But lawyers who litigate medical malpractice cases say claims against insurance carriers are low in Iowa and the legislation would make it impossible for injured Iowans to even try their case. The two Republicans on a Senate subcommittee advanced Senate Study Bill 3150. Current law limits noneconomic damages such as pain and suffering or loss of consortium to $250,000 unless the jury finds there is a substantial or permanent loss or impairment of a bodily function; substantial disfigurement; or death. The legislation would eliminate a jury’s ability to award more than $250,000 for noneconomic damages, regardless of the severity of the injury. Dr. Tiffani Milless of Iowa Pathology Associates said she has seen her medical malpractice premiums increase and she has had to increase her insurance coverage because of a legal climate that results in high awards. She said her main concern was the effect on access to care and the ability to recruit…

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January 2020 Newsletter

Iowa mothers facing fewer options for labor and delivery A rising trend of Iowa maternity ward closures is having a domino effect on expectant mothers and access to prenatal care. With 12 maternity wards closing statewide between 2016 and 2018, the already rural state is leaving soon-to-be mothers with fewer options – further away. Once known as a state offering a reasonable medical liability climate, recent sky-high judgements have impacted the willingness of physicians and hospital systems to remain in practice. Between 2017 and 2019, Iowa juries awarded plaintiffs more than $63 million in non-economic damages, adding up to nearly three times the $21.4 million awarded in economic damages. Now, half of Iowa’s counties lack any maternity services at all. “This situation drives up health care costs for all Iowans as malpractice insurance premiums rise, while putting patients, doctors and hospitals at risk,” writes Dr. Marygrace Elson, an OBGYN practicing in Iowa City and president of the Iowa Medical Society, in a recent op-ed. Ranking last across all states in the number of OBGYNs per 10,000 women, medical liability reform is a must, Elson emphasizes. To read more about the need for the Iowa legislature to take action on liability…

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A malpractice cap can help maternity care access

SOURCE: The Gazette Last summer, Marshalltown’s UnityPoint hospital shuttered its maternity ward. The year before that, Washington County Hospital in southeast Iowa did the same. These closures weren’t outliers. According to the Iowa Department of Public Health, 28 Iowa hospitals stopped delivering babies between 2001 and 2018. Nearly half of those maternity wards (12) closed within a two-year span, from 2016 to 2018. We’ve known about some of the contributing factors for a long time — our shrinking and aging rural populations don’t need as much maternity care, and Medicaid reimbursement rates are too low to keep maternity services viable at more remote, financially strained facilities. But within the past few years, there is another concern: sky-high awards and settlements in medical malpractice cases. When I moved to Iowa 20 years ago, Iowa enjoyed the reputation of practical and reasonable juries and malpractice judgments — attractive for a physician looking for a place to practice. When a patient was injured, a jury would determine how much money they should award to cover “economic damages,” including things like treatment costs and lost wages. If indicated, juries could also order doctors and hospitals to pay “punitive” damages. But sometimes when a patient…

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November 2019 Newsletter

Iowa’s liability climate is changing – for worse The Iowa Medical Society (IMS) highlighted how the state’s medical liability climate is shifting and threatening access to care in the Fall edition of Iowa Medicine. In 2017, a series of reforms including certificate of merit and expert witness requirements were implemented to drive down the number of meritless lawsuits filed in the state. Unfortunately, at the time, reasonable limits on non-economic damages were included only as a “soft cap,” allowing the limit to be waived by a jury in certain instances. MaryGrace Elson, MD, MME, FACOG, President of IMS and an OB/GYN from Iowa City, highlights the outcome of the soft cap in the edition’s feature story, “Our Medical Liability System in Crisis.” “In the past three years, Iowa’s medical liability climate has shifted dramatically,” she notes. “… Iowa’s trial bar has begun cherry-picking cases where there is no dispute that a medical error occurred. Employing questionable tactics that play to juries’ emotions and drive up award expectations, we have seen a string of high-dollar verdicts against physicians and facilities.” Over the past two years, just five lawsuits have led to awards of $63 million in noneconomic damages, and impacted patient…

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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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