Patient protection: Good Samaritan legislation introduced in Congress

The Good Samaritan Health Professionals Act of 2023 was re-introduced in the House of Representatives this month, to close the gap in available medical coverage during federally declared disasters and public health emergencies.

H.R. 2819, introduced by Representatives Larry Bucshon (R-IN) and Raul Ruiz (D-CA), both physicians, would protect medical volunteers from lawsuits when their services are needed most.

Due to inconsistencies in federal and state laws, some of these volunteer health care professionals have been turned away or limited in the scope of their assistance because of the threat of medical liability lawsuits.

Congress moved quickly to include health care volunteer liability protections in the Coronavirus Aid, Relief, and Economic Security (CARES) Act in 2020, allowing for the availability of volunteer health care professionals during the COVID-19 pandemic without the threat of liability lawsuits. Unfortunately, that legislation was limited to the treatment of COVID-19 and did not extend past the pandemic to other public health crises.

The Good Samaritan Health Professionals Act of 2023 respects existing medical liability laws in individual states, while creating a more comprehensive and clear approach to medical volunteerism – and reducing medical lawsuit abuse against those providing care when Americans need it most.

To learn more about H.R. 2819, click here.

Physician supervisors of PAs, NPs face liability balancing act

Physician assistants (PAs) and nurse practitioners (NPs) play an essential role in many health care systems, but supervising these providers is not without liability risks.

Now, recent court cases show that physicians may be underestimating the risk of employing or supervising PAs and NPs, shedding light on what more they need to do to mitigate the impact of medical lawsuit abuse. Most critical is that the physicians’ supervisory responsibilities are included in a collaborative agreement with PAs and NPs, and roles and scope of work are clearly defined.

A recent study found that the vast majority of lawsuits against NPs and PAs – 82 percent of those studied between 2011 and 2016 – also name the supervising physician. In some cases, the NP or PA who treated or diagnosed a patient may eventually be dropped from the lawsuit, leaving the supervising physician fully liable for treatment decisions of those they supervise. This is the case even in states where PAs and NPs have more autonomy in their ability to practice medicine because physicians may still be liable for their alleged negligence by virtue of being their employers.

In states that have taken steps to limit physician oversight of NPs, “liability can then shift to the NP when the NP is fully independent,” said Cathy Klein, an advanced practice registered nurse.

Physicians can reduce the liability of collaborating NPs and PAs through intensive training, verification of their scope of practice, and engaging with them and their patients through consultation. To read more about the balancing act physicians face in employing NPs and PAs to increase access to care in their practices, click here.

Liability premiums put pressure on physicians

Medical liability insurance premiums have grown significantly in recent years, reaching their fourth consecutive year of increases and straining practicing physicians in health care systems across the country.

According to a new report from the American Medical Association (AMA), policy researchers are anticipating these increases will accelerate defensive medicine and reduce the physician supply, leading to limits in access to care – particularly among medical specialists.

Fifteen states reported double-digit percentage increases in premiums in 2022, up from 12 in 2021. Illinois leads the latest list of states with the largest proportion – nearly two-thirds – of premiums that increased 10 percent or more. Most striking was a 40 percent premium increase seen in Kansas.

“For physicians who can still obtain coverage in a hard market, the skyrocketing costs may force physicians to relocate away from certain high-cost states or drop certain critical services that raise their liability risk,” said AMA President Jack Resneck Jr., M.D.  “These tough choices can lead to reduced access to care for patients.”

These premium increases are driven by a number of factors, including rising jury awards and higher costs for defending against such claims.

Together with the HCLA, the AMA continues to push for common sense federal medical liability reforms, including reasonable limits on non-economic damages, to reduce health care costs and protect patient access to care.

The AMA’s analysis on medical liability insurance premiums is based on an annual survey of professional liability insurers conducted by the Medical Liability Monitor (MLM) and can be found here.

New Mexico patients to benefit from liability fix

A poorly written law that lumped outpatient health facilities with hospitals, with liability payouts to match, finally came to a compromise revision by New Mexico’s elected officials to the benefit of patients across the rural state.

As previously reported, a health care crisis loomed on New Mexico’s horizon if a fix was not found to how outpatient facilities were treated when it came to liability requirements.

By 2024, potential awards in liability lawsuits against some outpatient facilities were set to rise from about $800,000 to $5 million.

Senate Bill 523 was introduced late in the legislative session to adjust the wording of the Medical Malpractice Act to redefine what is an independent or outpatient medical practice versus hospital owned, and it established lower limits on non-medical care related damages accordingly.

Now, these outpatient facilities are subject to a reduced limit of $750,000 in 2023, and $1 million in 2024 for damages other than past and future medical expenses if medical negligence is found.

“…You have very few doctors [in New Mexico] who are dealing with volume and if there’s large volume, we’re taking more patients and we get more complex patients by the time they come in. And so all of those things increase our liability,” said Dr. Cynthia Settles, a pediatrician at Full Bloom Pediatrics in Las Cruces.

Governor Michele Lujan-Grisham signed the bill in early April, touting that the fix “confirms and assures that we protect patients by making sure that independent practices like the ambulatory surgical centers can in fact get insurance to protect the practice and the patients if there’s an issue.”

To read more about how the legislative fix will enable outpatient clinics to serve rural patients and attract physicians, click here.