New Mexico damage cap increase threatens patient care access

By Stephen Freedman New Mexico Source

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  • June 28, 2019

SOURCE: Las Cruces Sun News

New Mexico ranks 48th out of 50 states for access to healthcare. Various factors restrict New Mexicans’ access to care, including the rural nature of much of the state, an aging patient population needing more appointments, a large portion of the physician population nearing retirement and crippling student loan debt that has many new physicians seeking higher compensation elsewhere. With access to care already threatened, New Mexico should not pursue legislation that would add to the burden by increasing physician liability and encouraging physicians to close their doors and practice elsewhere.

Even for a largely rural state, New Mexico’s overall density of medical professionals is well below the national benchmark. “In New Mexico,” says Paul Sanchez, MD, Albuquerque ophthalmologist and president of the Greater Albuquerque Medical Association, “we are desperately underserved by physician providers.” Faced with months-long waits for appointments, many New Mexicans seek care outside the state — or don’t get treatment at all.

Meanwhile, healthcare organizations are struggling to recruit physicians. Many new physicians graduate with around $200,000 in student loan debt — and New Mexico’s physician compensation is among the lowest in the nation. With 31 percent of the population of New Mexico covered by Medicaid or CHIP, either of which pays less per visit than Medicare or private insurance plans, many practices are already under significant financial pressure.

Into this environment comes a proposal to raise caps on non-medical damages in medical malpractice suits. During the 2019 legislative session, the New Mexico Trial Lawyers Association backed legislation that would have raised the cap on non-medical damages for individual physicians from $600,000 to $2 million, with an annual cost of living adjustment. For medical entities — and the proposed legislation would define many small practices as medical entities — non-medical damages would be capped at $25 million. Medical damages would remain unlimited as they are in current law. This proposal would substantially increase risks for insurers, and consequently the medical malpractice premiums for physicians and practices throughout the state.

Michael Kaufman, MD, of Taos Medical Group, who has practiced internal medicine in Taos for over 40 years, put the situation in stark terms: “If this goes through, we’re out of here.” Dr. Kaufman said he did not see how his four-physician, three-nurse-practitioner practice could stay afloat while paying much higher insurance premiums under a $2 million cap. Financially, he says, “primary care practices are already on the edge.” Dr. Kaufman thought it likely that many other rural practices would close: “This would be a real danger to rural healthcare.”

Even a less dramatic rise in non-medical damage caps would impact practices’ ability to recruit physicians, given better compensation in bordering states. Dr. Sanchez knows these concerns are shared by practices and groups across the state.

The New Mexico Medical Society, the New Mexico Hospital Association and other organizations also opposed the proposed legislation, which was defeated due to the outpouring of opposition by the healthcare community demonstrating their concern for their patients’ access to healthcare. It is anticipated that legislation will be introduced in a future legislative session that will once again seek to raise the cost of healthcare in New Mexico. Lawmakers and the governor are expected to put tremendous pressure on the medical community and the trial lawyers to come to an agreement about how to resolve issues with the state’s cap on non-medical damages.