March 2015 Newsletter

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  • March 31, 2015

Congress Comes Together on Medicare Reimbursements, Closes Liability Loophole

By an overwhelming bipartisan vote of 392-37, Members of Congress last week came together to agree on an overarching measure that would protect patients and eliminate constant uncertainty over Medicare reimbursements.

Passed on Thursday by the House was a permanent fix to the Medicare Sustainable Growth Rate (SGR) formula that included language from the Standard of Care Protection Act to close a loophole in federal healthcare laws and regulations that may unintentionally open up new avenues for the pursuit of meritless lawsuits.

The quality measures and payment methodologies contained in the Patient Protection and Affordable Care Act are intended to measure the impact of health care delivery and payment systems; they cannot be exploited as the basis for a legal claim or cause of action for negligence against physicians and other health care providers. To protect against the potential for new liability exposure, it is clear that explicit protections are needed.

“Under the bill that passed the House, no longer could federal health care programs be used, outside their intended purpose, to create new standards of care for medical liability lawsuits,” said Mike Stinson, HCLA Chair. “We are pleased with the bipartisan work of the House to protect the physician-patient relationship, and to ensure that beneficial healthcare guidelines are not abused in an attempt to gain leverage in the legal system. We hope the Senate will act soon to pass this important legislation.”

President Obama also applauded the work of the bipartisan supporters of the bill and has indicated that he is looking forward to signing the bill into law, thus putting an end to both temporary Medicare reimbursement solutions and unintended federal liability loopholes.

To read more about the bipartisan passage of this critical piece of health care legislation, click here.

Missouri Senate Stands with Patients on Reform Measures

Following the 2012 nullification of Missouri’s limits on non-economic damages, state legislators are again reaffirming their commitment to patient access to care through the passage of medical liability reforms.

Called to act by skyrocketing insurance premiums for physicians and a poor liability climate, the Missouri State Senate approved a two-tier system of reasonable limits on non-economic damages to ensure deserving patients are properly compensated, and in a timely manner.

“By reinstating caps on non-economic damages in medical malpractice lawsuits, we will reduce incentives for these frivolous lawsuits,” said Senate Leader Tom Dempsey. “Overall, it means more accessible health care for all Missourians.”

Supporters of the bill understand that legislative action is required to reinstate reforms and ensure high quality medical care at affordable costs for patients across the state. The bill now heads to the House for consideration.

To read more about the passage of medical liability reforms in Missouri, click here.

Too Many Tests

With physicians performing an ever-increasing battery of tests, findings show a lack of medical reasons to do so and that many are done based on the fear of liability lawsuits.

A new survey, detailed in the journal Academic Emergency Medicine, found that more than 85 percent of physician respondents admitted that in general, they call for too many tests, even if they know the results won’t really help them decide how to treat their patients. Ninety-seven percent of respondents admitted to ordering unnecessary imaging tests.

Ordering tests without a justifiable need contributes to the practice of defensive medicine and adds up to $210 billion in health care costs each year.

This practice, and its sky-high impact on health care costs, could be reduced or eliminated with the passage of comprehensive federal reforms that would reverse the fact that “physicians feel enormous pressure to behave in a way they may not want to,” said Dr. Hemal Kanzaria, an emergency room physician at University of California Los Angeles and lead author of the study.

To read the Time Magazine analysis on the survey and the impact of physician perspectives on our health care system, click here.

Meritless Lawsuits Down, Access to Care Improved in Wisconsin

With a stable liability environment for physicians in Wisconsin, the number of lawsuits has decreased, allowing physicians to focus on their patients in the exam room and avoid unnecessary visits to the courtroom.

Preserving the patient-physician relationship, liability reforms in Wisconsin have continued to strengthen over the years and now include a requirement to bring cases in front of a mediation panel in order to determine those that are valid, and those that are without merit. The state also manages a fund to pay out claims to deserving patients more efficiently.

Mark Grapentine of the Wisconsin Medical Society said benefits of these efforts are paying off for doctors and patients.

“It is important that physicians and the medical community have the opportunity to practice health care in the way they” see as best for the patient, Grapentine said, adding he often hears from medical associations in other states. “They wish they had as stable an environment as we do in Wisconsin.”

This is good news for everyone in Wisconsin seeking medical care. To read more about how efforts in Wisconsin have reduced lawsuits and are benefitting patients and physicians, click here.