Pennsylvania’s highest court on Thursday took the controversial step of reversing a two-decade-old rule aimed at tamping down a crisis of doctors leaving the state because of high medical malpractice insurance costs.

In a highly-anticipated order, the state Supreme Court directed that plaintiffs can resume filing medical malpractice cases in any county in the state, rather than restricting them to filing in the county where the alleged medical harm occurred.

The change, which takes effect in January, is a huge win for trial lawyers in the state, who have long argued that limiting plaintiffs when it comes to the venue is unfair because juries in some counties, especially in more conservative rural areas, are seen as far less friendly to malpractice claims than others.