Category Archives: Newsletter

February 2019 Newsletter

PA Supreme Court avoids rush to judgement on liability rule changes The Pennsylvania Supreme Court announced it would delay a proposal that could encourage medical lawsuit abuse across the state. At issue is a proposed rule change that would allow lawsuits to be filed outside of the county where the incident in question occurred. The announcement followed a request by the state Senate to study the issue further before any changes are made. The legislature’s Budget and Finance Committee will look at how the location where liability lawsuits are filed impacts access to care, costs, and compensation. Fifteen years ago, lawsuits could be brought forth in any county where the doctor or hospital did business. Philadelphia, which built up a reputation for its litigious environment, became the city of choice for personal injury attorneys “venue shopping” their lawsuit. The Senate’s report is due to the Pennsylvania Supreme Court by Jan. 1, putting a hold on any changes this year. To read more about the proposed changes in Pennsylvania’s liability laws, click here. Costs remain crippling even as liability lawsuits decline While the frequency of medical liability claims show a positive downward trend, the cost of defending a lawsuit and average…

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January 2019 Newsletter

Pennsylvania liability rule change could lead to increase in lawsuit abuse A rule that helped stabilize the medical liability market in Pennsylvania faces the threat of repeal, bringing worry that medical lawsuit abuse could return. Implemented in 2002, reforms mandated that medical liability claims could only stand trial in the county where the alleged medical error occurred to avoid “venue shopping” lawsuits to courts that had a history of favoring large verdicts and personal injury attorneys. The Pennsylvania Supreme Court now proposes eliminating that rule, allowing victims to file lawsuits in any county where the defendant does business — even if the incident in question occurred elsewhere. A coalition that includes the Pennsylvania Medical Society (PAMED), the Hospital and Healthsystem Association of Pennsylvania (HAP), and the Pennsylvania Coalition for Civil Justice Reform (PCCJR) cites this rule as the primary reason the system has stabilized to its current point. “If history is any indication, this could have devastating effects on patient care,” said Danae Powers, MD, president of PAMED. “In the years before we restricted venue shopping, medical liability premiums rose so quickly that some physicians couldn’t obtain the insurance they needed to treat patients. Others chose to leave Pennsylvania or…

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December 2018 Newsletter

An opinion on collateral source reform in Florida A recent op-ed by a former Florida legislator highlighted the dysfunction in the state’s liability system, including how the lack of collateral source reform in medical liability cases has led to inflated and unnecessary costs. Don Brown, previously a representative in the Florida House, weighed in on Florida’s recent number two position on American Tort Reform Association’s “Judicial Hellholes” list – and on one of the driving factors of increased liability across the state. “These inflated costs are exacerbated by the fact that Florida prohibits juries from seeing the payments made to plaintiffs by outside parties such as insurance companies,” Brown wrote. The issue at hand is the collateral source rule, where a defendant is prohibited from introducing in court any evidence of payments received by the plaintiff, from sources other than the defendant, which might remedy some of the plaintiff’s economic losses. The result is double recovery of damages by plaintiffs since both the defendant and another party, such as an insurance company, pay for the same loss. “The first, and most obvious solution, is to allow juries to see any outside compensation received by the plaintiff for treatment,” Brown suggested….

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November 2018 Newsletter

Arkansas court ruling prevents counting medical liability votes Progress on liability reform in Arkansas hit a snag this fall, as a court ruling ahead of November elections hurt efforts for reforms to move forward. Medical liability reforms championed by Arkansas for Jobs and Justice, including limits on attorneys fees and reasonable caps on non-economic damages, were slated to appear on the November ballot as Issue 1. Initial circuit court challenges to the legitimacy of the ballot question due to the state’s single-subject test were appealed, but ultimately upheld by the state Supreme Court. Although the question still appeared on the ballot, the vote totals were not counted. While vote counts for some counties were released under a Freedom of Information Act request, Carl Vogelphol, campaign manager for Issue 1 proponent Arkansans for Jobs and Justice, said it was hard to know if the issue would have passed or not, but that “we were seeing internal data when the electorate was educated they would’ve voted for it.” To read more about the setback for Arkansas access to care, click here. Kentucky courts remove checks on liability lawsuit merits Legislation passed in 2017 that put in place a plan to ensure the…

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October 2018 Newsletter

Elderly Texans among the beneficiaries of liability reform Liability reforms were a long time coming for the long-term care industry in Texas, where, prior to 2003, half the nursing homes across the state couldn’t find or afford liability insurance. Highly rated nursing homes were frequently targeted by personal injury attorneys pursuing meritless claims, driving up costs that forced them to scale back their care. Big changes came following medical liability reform legislation passed in 2003, when the nursing home industry in Texas experienced dramatic improvements in the care they were able to provide their residents – all thanks to savings from liability insurance premiums. “Texas tort reform saved our organization and the residents that we serve,” said Alan Hale, CEO of Manor Park, a non-profit elderly care facility in west Texas. Now, Texas has 50 percent fewer cases against nursing homes than the national average – evidence that reforms are making an impact. Facilities throughout the state, including Manor Park and another non-profit, Morningside Ministries, have credited liability reforms with allowing them to invest resources in recruiting care staff and nurses, training younger people for the various careers in long-term and elderly care, and improving the homes that serve and…

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September 2018 Newsletter

Texas hold ‘em: 15 years since reform In the 15 years since comprehensive medical liability reforms were enacted, Texas has held on to physicians – and held off those seeking to return to a time when patient access to care was at risk. Initially enacted in 2003, liability reforms have resulted in an influx of physicians, benefiting rural residents across the state. “Texas’ medical liability reforms have been nationally considered the gold standard for medical liability legislation,” said Governor Greg Abbott. “Tort reform has significantly reduced lawsuits and liability costs in our state and contributed greatly to the increasing number of doctors practicing in Texas.” Women’s health care services have also improved, with Texas Alliance for Patient Access (TAPA) Chairman, Dr. Howard Marcus, confirming that Texas has added more obstetricians than any state in the nation. “Because of the tort reform measures passed by the Texas Legislature in 2003, the number of Texas primary care, high-risk, and total physicians have expanded at a rate greater than population growth,” Dr. Marcus said. To read more about the work of TAPA and the 15-year liability reform milestone, click here. A physician’s perspective on jackpot justice A spine surgeon and editor-in-chief of AAOS…

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August 2018 Newsletter

The reality of defensive medicine With projections about the cost implications of defensive medicine in the hundreds of millions of dollars, a new study showed greater insight into how physicians treated patients when they were not subject to the threat of lawsuits. The reality of defensive medicine became apparent when researchers from Duke and MIT, on behalf of the National Bureau of Economic Research, focused on active-duty military who were treated by government health care systems that are protected from medical liability lawsuits. When compared to treatment received by active-duty military from civilian medical professionals who are subject to liability, the study found “suggestive evidence that liability immunity reduces inpatient spending by 5% with no measurable negative effect on patient outcomes.” The study did an in-depth analysis on quality indicators to be sure doctors weren’t providing substandard care, and found no instances where the quality of care in the military health care facilities appeared to be worse. “Our analysis demonstrates that the active duty receiving care on the base are treated notably less intensively, without any health outcome consequences. Considering the lack of liability recourse for his treatment group, this pattern of results is suggestive of a strong degree of…

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July 2018 Newsletter

Wisconsin court preserves reforms – and access to care A decision this month by Wisconsin’s state Supreme Court kept intact liability reforms that have placed reasonable limits on noneconomic damages and resulted in lower health care costs for patients and physicians. The court upheld the state’s $750,000 limit on non-economic damages while continuing to guarantee that deserving patients would receive full and unlimited compensation for past and future medical care as well as lost wages. “Today’s Court decision preserves Wisconsin’s balanced medical liability system that has been instrumental in attracting physicians to communities across Wisconsin, while providing assurance to injured patients that they will receive payment for the full amount of a jury’s award of medical expenses, lost wages, and other economic losses,” Wisconsin Hospital Association President Eric Borgerding stated. The state maintains an Injured Patients and Families Compensation Fund using assessments charged to physicians, clinics, hospitals and other participants and covers all damages above their primary insurance limits. Premiums paid by physicians to the fund have been dropping since 2014, with rates falling by 34 percent in 2016, 30 percent last year and an anticipated drop of another 30 percent this year. This month’s decision comes as a reversal…

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June 2018 Newsletter

Liability reform empowers physicians to avoid defensive medicine While evidence strongly suggests that the potential for liability lawsuits results in treatments and tests that may not be otherwise necessary, new data shows that medical liability reform may be empowering physicians to go on the offensive together with their patients. A newly published analysis compared diagnosis and treatment patterns in patients suspected of having coronary artery disease between states where liability reforms have been adopted and states without non-economic damage limits in place. The study included 36,647 physicians in nine states with reasonable limits adopted between 2003 and 2005, and 39,154 in states that had not taken any action to utilize limits on non-economic damages to rein in lawsuits. Physicians in states with reasonable liability limits were less prone to rely on angiography as a first diagnostic test and more likely to order noninvasive stress testing, the report found. In addition, fewer patients were referred for angiography following initial stress testing. These physicians also performed fewer percutaneous coronary intervention (PCI) procedures after ischemic evaluation, with indications that these patients were offered medical therapy as an alternative. “Our study suggests that physicians who face lower malpractice risk may be less concerned with…

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May 2018 Newsletter

Maryland trial court attempts to redefine liability standards Under consideration by Maryland’s highest court is a case that attempts to redefine professional standards of care – and negate the testimony of expert witnesses. The basis of the case stems from a medical liability trial in which instructions provided to the jury deviated from well-established law on measuring standard of care as what a ‘reasonably competent’ physician would be expected to do, per expert witness testimony. Instead, the jury was instructed to consider only what a ‘reasonable layperson’ would do – potentially warping how physician negligence is defined. The Litigation Center of American Medical Association and State Medical Societies joined the Maryland State Medical Society (MedChi) and the Medical Mutual Liability Society of Maryland in filing an amicus brief that not only cited the likely increase in meritless lawsuits and implications for standards of other professionals in court, but also noted that experts must be relied on because medical procedures are not common knowledge. “Letting juries nullify professional standards would upend the basic premise that professional malpractice claims involve specialized knowledge and duties that laypeople cannot assess based on their common knowledge,” the brief states. A lower appeals court agreed that…

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