Category Archives: Kentucky

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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Medical malpractice review panels bring sanity to a broken legal system

The Aug. 5 story by Andrew Wolfson on Kentucky’s new Medical Review Panel (MRP) process would have readers believe our legal liability system was working flawlessly before the new law was enacted. Perhaps that was true for the personal injury lawyers and TV stations that air their incessant commercials. But nothing could be further from the truth for the rest of us. To the detriment of businesses, caregivers — and ultimately consumers — Kentucky is one of the most litigation-friendly environments in the country. In fact, the U.S. Chamber of Commerce Institute for Legal Reform ranks Kentucky 43 out of 50 states for our legal liability climate. Worse, Kentucky is trending in the wrong direction. In 2015, we ranked 37. For example, it’s so bad that Kentucky considers the normal, human act of a doctor apologizing to a patient who did not receive an outcome they hoped for as an admission of guilt! Establishing the MRP process in Kentucky was the first step toward bringing our legal climate in line with neighboring states like Indiana, Tennessee and West Virginia — all of which have pursued reforms to preserve a consistent, level-playing field in the justice system. In turn, these states…

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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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Kentucky’s legal liability climate leading to higher costs for everyone, lawmakers say

With Kentucky continuing to rank among the worst in the country in terms of legal liability climate, legal liability reforms are at the forefront of legislative discussions for many policymakers in the state. Sen. Ralph Alvarado, a doctor from Winchester, said one of the main issues with Kentucky’s legal liability climate is doctors in the state practicing “defensive medicine,” which he said means health care professionals having to worry more about liability and being sued than the case at hand. “You order tests to look for things that are rare and that are improbable just because if you happen to miss something you’re going to get potentially sued. So, you order the tests for things that are probably unnecessary, that add a lot more cost to health care. You might admit someone to the hospital just in case when it probably doesn’t need to happen,” Alvarado said. While some legal liability measures have passed through the General Assembly in recent years, Alvarado says there is still more work to be done. One initiative in the 2018 session that didn’t see passage was a bill to place a constitutional amendment on the ballot in November to let voters decide if the…

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AMA’s legal team helps protect medical liability reforms

Medical liability reform is a high state legislative priority for the AMA. Not surprisingly, then, it is also a high priority for the Litigation Center for the American Medical Association and State Medical Societies. Evidence of this is the Litigation Center’s involvement in five active tort reform-related cases before the state Supreme Courts of Kentucky, Michigan, Nevada, Oregon and Texas. And evidence of the Litigation Center’s success is the recent Wisconsin state Supreme Court 5–2 ruling that the state’s $750,000 cap on awards for noneconomic damages did not violate the state constitution. The Wisconsin cap on noneconomic damages is one component of a three-part strategy that has stabilized the state’s medical liability environment. The three elements are: A requirement for most physicians to carry $1 million in liability coverage per occurrence and $3 million in aggregate. The Wisconsin Injured Patients and Families Compensation Fund, which is financed via assessments (based on actuarial risk) charged to physicians, clinics, hospitals and other participants and covers all damages above the primary insurance limits. The $750,000 cap on noneconomic damages. Many caps, few guarantees Wisconsin and 30 other states have a cap on noneconomic damages. But the Dairy State is one of just a…

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March 2018 Newsletter

Bad examples: New York, Pennsylvania lead national liability rates Without reform to keep medical lawsuit abuse in check, examples of the inefficiencies of our nation’s liability system are emerging in several states in the form of increasingly large payouts. According to a recent survey by Diederich Health Care, a medical liability insurance and consulting company, New York topped the list for the largest liability payouts in 2017 with a total of nearly $618 million, with Pennsylvania second at $342 million and Illinois not far behind with $301 million. What do these states have in common? None have reasonable limits on non-economic damages in place, with liability climates that have worsened in recent years due to lawmakers who are more likely to push for changes that benefit personal injury attorneys rather than patients. In New York, 30,000 members of the Medical Society of the State of New York opposed extending the state’s statute of limitations on liability claims because it would increase their already high liability costs and drive more doctors out of the state. Unfortunately, the law passed, lengthening the statute of limitations from 15 to 30 months, beginning not when the error occurred, but the date at which the…

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Medical tort-reform bill moves to House

FRANKFORT, Ky. — The Senate approved an omnibus medical tort-reform measure yesterday that would regulate everything from trial attorney fees, medical record copying charges and which malpractice lawsuits can advance in the courts. Among its many provisions, Senate Bill 20 would require medical malpractice lawsuits to contain an affidavit of merit. That’s a document stating that at least one doctor agrees the claim has merit. A medical review panel opinion in favor of a patient would fulfill the affidavit of merit requirement. Senate Bill 4 from 2017 created panels of experts to review claims of medical error or neglect. If the medical review panel finds in favor of the medical provider, however, the patient would still have to get an affidavit of merit to advance to court. A second provision would impose contingency caps on attorney fees in medical malpractice cases. An amendment would set those caps at no more than 33 percent of any awarded damages. “Some will argue this is an infringement on the free market,” Sen. Ralph Alvarado, R-Winchester, who introduced the legislation. “I feel it is a protection against predatory legal practices in Kentucky.” A third provision is known as the “I’m sorry” clause. It would…

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February 2018 Newsletter

Show me liability reform A recent push for liability reform in Missouri could show patients how a reduction in medical lawsuit abuse can improve access to care across the states. Building on Governor Greitens’ emphasis on the need for changes to the state’s liability system, a new bill would bring an efficient resolution to those with legitimate claims. The latest bill, introduced by State Senator Dan Hegeman, allows physicians to address claims promptly by redefining the statute of limitations to three years. “Missouri has not amended the five-year statute since 1939,” Hegeman told the Senate government reform committee. “While five years may have made sense in an age when transportation and communication were more challenging, there is no reason today for an injured person to need so much time to file the action.” The shorter statute of limitations gives physicians peace of mind that any claims of negligence are addressed quickly, and deserving patients benefit from a system that better separates meritless lawsuits from rightful claims for damages. To read more about Missouri’s efforts to further reform their liability system for patients and physicians, click here. Sweeping changes to liability system would bring benefits to Kentucky Initiating legislation that would…

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Tort Reform Roundup: Kentucky & Missouri

In this edition of Tort Reform Roundup, we look at a pair of states considering some major tort reform initiatives. In Kentucky, a sweeping measure aimed at capping attorney fees on medical malpractice damages, has passed the State Senate Health & Welfare Committee and now awaits a vote in the Senate. Meanwhile, the state of Missouri is mulling over a proposal that would shrink the time for filing personal injury lawsuits. Kentucky The state currently has no cap on damages in any type of injury. State Senator Ralph Alvarado aims to change that with SB-20, a bill that seeks to impose contingency caps on attorney fees in medical malpractice cases. The limits in this provision would allow a lawyer to make $60,000 of contingency fees if their client wins $200,000 in damages, or $140,000 if their client wins $1 million in damages. Other provisions would exempt medical peer review discussions from discovery, require medical malpractice lawsuits to contain an affidavit of merit (a document stating that at least one doctor agrees the claim has merit), and allow healthcare workers to express condolences to patients or families without fear of having those words used against them in a lawsuit. Alvarado has…

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Senate panel explores medical tort-reform bill

FRANKFORT, Ky. — A sweeping measure to regulate everything from trial attorney fees, medical record copying charges and how malpractice lawsuits are brought passed the state Senate Health and Welfare Committee yesterday. The legislation was described as an omnibus medical tort-reform bill by sponsor Sen. Ralph Alvarado, R-Winchester. Among its many provisions, Senate Bill 20 would require medical malpractice lawsuits to contain an affidavit of merit. That’s a document stating that at least one doctor agrees the claim has merit. A medical review panel opinion in favor of a patient would fulfill the affidavit of merit requirement. Senate Bill 4 from 2017 created panels of experts to review claims of medical error or neglect. If the medical review panel finds in favor of the medical provider, however, the patient would still have to get an affidavit of merit to advance to court. A second provision would impose contingency caps on attorney fees in medical malpractice cases. The limits in this provision would still allow a lawyer to make $60,000 of contingency fees if their client wins $200,000 or $140,000 if their client wins $1 million, according to the language in SB 20. A third provision would attempt to exempt medical…

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