ANNAPOLIS – A work group of House delegates Thursday turned out a list of recommendations to curb soaring medical malpractice insurance prices that is likely to turn into the bill to watch on the issue.
The panel’s recommendations were inserted into a Senate bill, SB 1299, that should get a positive vote in the House Judiciary Committee today.
The death of the governor’s malpractice bill in the Senate Judicial Proceedings Committee Friday put increased pressure on the House to turn out an acceptable bill.
Several other medical malpractice bills are snagged in the House Judiciary and Economic Matters committees, but will most likely be held without a vote if the revamped bill is approved today.
After nearly two weeks of hearings, a work group of delegates commissioned by House Speaker Michael E. Busch, D-Anne Arundel, concluded that increasing economic damages awarded by juries have driven the rise in malpractice insurance premiums. Insurers have said doctors may face a 40 percent increase in premiums next year.
The group produced eight recommendations, six of which they said should be included in the final bill.
Dueling parties in malpractice suits should be required to mediate before being scheduled for trial, said the group.
Mediation is often successful in resolving disputes because it brings the many parties involved in malpractice suits together, and gives them a third-party opinion, said Delegate Joseph F. Vallario, D-Prince George’s.
“Once they get in the room, there’s someone saying, ‘I don’t have a dog in this fight, but this is what I think the outcome will be,'” said Vallario.
If mediation doesn’t work, a patient should have to file an enhanced certificate of merit giving certain details on the claim, the group suggested.
The more stringent certificate of merit could become the basis for pretrial hearings, such as a motion to dismiss the claim, said group chairman Delegate Anthony G. Brown, D-Prince George’s.
Additionally, the group suggested reducing the 7 percent commission for brokers to 5 percent. On a malpractice policy for an obstetrician/gynecologist, a broker could make $8,050 for just renewing an existing policy. The cap would put the fee at $5,750.
Cases also should be heard in the originating jurisdiction, the group determined, an effort to restrict venues for bad-faith settlements against malpractice insurers. Most cases are heard in Baltimore City, a jurisdiction known for being generous to plaintiffs in these cases.
Another solution was mandatory remittitur — a legal term to say that defense lawyers have to ask judges to reduce awards that include past medical costs the patient didn’t actually pay for, such as bills covered by health insurance.
Finally, the group suggested an annual report by the state insurance agency on the affordability of medical malpractice insurance in Maryland. The group also recommended a task force study long-term solutions, but it did not list it as part of the eight prospective bill components.
The two additional suggestions were tabled with the news that a Senate committee had killed the governor’s malpractice bill Friday.
The first of those recommendations concerns consolidating complaints. Now if a patient dies as a result of malpractice, his estate can sue for malpractice as well as wrongful death. Each suit has its own pain-and-suffering cap, which allows a plaintiff to reap more than $1.5 million in non-economic damages. The work group suggested the actions be joined to fall under one award of no more than $915,000.
The group also hoped to squeeze insurance premiums so that lower-risk specialties — such as psychiatrists — would compensate higher-risk practitioners — such as obstetricians.
“It’s kind of like a pyramid, because what happens is, you’ve got a lot of low-risk specialties and a few high-risk specialties,” said Brown, who said by adding $2,000 to the premium cost of low-risk specialties you might reduce the highest premiums by up to $40,000.
The plan was opposed by Medical Mutual, a state-established insurer that is mandated by law to take all physician specialties. The company expected that private insurers would “cherry pick” their low-risk customers and send rates for high-risk specialties soaring even higher.
Both of these proposals were expected to draw enemies in the Senate, and the group suggested leaving them out of the bill altogether.
“It is neither a Band-Aid approach nor a final solution,” Brown said, “but it is a solution that will lead us in the right direction.”
– 30 – CNS-3-25-04