White Coat Rally for Tort Reform in Missouri

Tort Reform in MissouriAs we have noted before, caps on non-economic damages in medical malpractice cases have been challenged in many states and on many fronts over the last few years.  Most recently Californians rejected a proposal (Proposition 46) not to ban the state’s cap, but to increase it dramatically.  However, in other states the caps have been done away with altogether through judicial ruling.  Many state Supreme Courts have overturned damage caps on grounds that range from undue interference with jury trials to procedural objections regarding the manner in which the legislation was written or approved.

In July of 2012 the Missouri State Supreme Court ruled that limits on awards for non-economic damages in medical malpractice lawsuits are unconstitutional.  Prior to that ruling Missouri had a cap in place of $350,000, which had been signed into law by the Missouri legislature and, then Governor, Matt Blunt in 2005.  Experts believe that this cap, along with other malpractice reforms, helped to stabilize the medical professional liability insurance market in Missouri. Additionally, these reforms led a number of companies to move into Missouri who had previously been unwilling to sell policies to physicians and healthcare workers in that state. Lawmakers and physicians now fear that the removal of this cap will lead to astronomical jury awards that will, in turn, bring about increased healthcare costs and an overall decrease in access to care.

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Podiatrists Unite!

Podiatry medical malpractice insurance speciallistsFrom time to time, we at eQuoteMD like to choose a particular specialty to address. Today we’re talking to podiatrists, and we have one primary message: consider a specialized provider like the Podiatry Insurance Company of America (PICA).

Podiatry is a unique specialty with unique risk management challenges best addressed by a medical professional liability insurance provider dedicated to that specialty. Podiatry is a relatively high-risk specialty because of both what it involves and whom it involves. Our feet are extremely important to our quality of life and they are also very complex, and in some ways fragile parts of our bodies. While the vast majority of the time podiatrists are able to offer quality care that improves people’s mobility and enjoyment of life, the fact is that there are going to be occasional instances of malpractice, but also there are going to be cases brought against doctors by people who have experienced adverse circumstances, whether their doctor was truly at fault or not. And, because our feet are so fundamental to mobility and quality of life, these patients are going to be seeking significant compensation in the suits they file.

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Medical Malpractice 2014 – Our Year End Review

Medical Malpractice 2014 Year End ReviewIt’s been a busy and exciting year for us here at eQuoteMD! As we come upon the holidays and the end of the year, we thought we’d review and remind you of some of the stories and articles we’ve published in 2014, and some of the themes that have been popular with our readers.

In the spring we did a five part series on defensive medicine and some of the various reform measures that have been proposed, and in some cases implemented, to limit it. Defensive medicine is a result of a litigious environment and in the end costs everyone involved.   You can read those individual posts starting here, or you can download our white paper, A Guide to Defensive Medicine, which compiles all of the information into one document available at our Information Center.

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California Damage Caps Not Out of the Woods Yet

California Damage CapsIf you thought that the defeat of Proposition 46 in the recent midterm elections signaled stability for California’s longstanding limits on noneconomic damage awards in medical malpractice cases you were wrong. On November 26, at the urging of Consumer Watchdog, the trial lawyer supported non-profit that was instrumental in funding the Proposition 46 campaign, the California Supreme Court announced that it would review the constitutionality of the nearly 40 year old statute that limits non-economic damages in California medical malpractice cases to $250,000.

California was the first state to enact a cap on non-economic damages, doing so in 1975, and served as a bellwether for other states that followed suit in the ensuing decades. The caps were put in place to control high medical malpractice premiums stemming from the inability of insurance companies to accurately quantify risk. With no limits on pain and suffering awards, and rather subjective models for quantifying the cost of pain and suffering, developing accurate risk assessment models was difficult. The caps placed a ceiling on that one aspect of malpractice damages that tended to be the most difficult to quantify and thus helped stabilize the market.

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$200 Million Dollar Settlement along with Reforms in Pennsylvania Malpractice Fight, but State will Keep What it Took

Pennsylvania Malpractice SettlementLast month Governor Tom Corbett’s office announced a settlement to a years long dispute between groups representing doctors and hospitals and the Pennsylvania state government.  In 2008 the Pennsylvania legislature, under then governor Ed Rendell, appropriated $100M from the state’s Medical Care Availability and Reduction of Error (Mcare) fund to the general fund to balance the state budget.  This in turn led to litigation, which challenged not just the action of the state in this one instance, but the nature of the formula used to calculate the assessments that doctors in the state are required to pay into the fund.

Pennsylvania, like several states, has a fund that doctors pay into which covers medical malpractice liability beyond a certain threshold.  Doctors in the state are required to carry $1M in malpractice coverage with the added stipulation that $500,000 of that is purchased in the private market, while the other $500,000 is covered by the Mcare fund, into which assessments are paid annually. The idea behind this system is, of course, to reduce the cost to doctors of maintaining adequate malpractice coverage. It was put in place as a reform effort to promote doctor retention and ease the burden on healthcare providers at a time when malpractice rates in Pennsylvania were quite high.

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Voters Reject Proposition 46: No to Random Drug Testing and Raising the Damages Cap

Proposition 46 rejected by CaliforniansCalifornia voters rejected Proposition 46 on Tuesday by a more than 2 to 1 margin. The ballot initiative, would have raised caps on noneconomic damages in malpractice cases from $250,000 to over $1M, required doctors to submit to random, state mandated drug and alcohol tests, and required doctors to utilize a state run database when prescribing certain types of drugs. The final vote, which came in at 67.1% against and 32.9% for represents a sound rejection of the measure, and while most expected it to fail the margin is striking.

Proposition 46 garnered national attention and a great deal of money because it was viewed as something of a bellwether. California was the first state to implement a cap on non-economic damages in 1975, and has not raised that cap since. Had proposition 46 passed the cap would have more than quadrupled overnight, which would have set a precedent for other states, more than thirty of which have placed some type of cap on noneconomic damages since California led the way.

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Election Day is Coming Up – What will be the Fate of Proposition 46?

Proposition 46 and Election DayProposition 46, what is it?

Proposition 46 is an initiative that will be on the ballot in California this coming Tuesday, November 4. The initiative has garnered widespread attention from both critics and proponents. The most outspoken critics have been doctors, malpractice insurers, and others in the healthcare industry, while the most vociferous proponents have been trial lawyers.

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So… About Ebola

Ebola and eQuoteMDOkay, we had to go there, right? But don’t worry, this isn’t another piece on 10-Steps-to-Protect-Yourself-from-the-Coming-Pandemic, or 50-Things-You’re-More-Likely-to-Die-From-than-Ebola post. We just thought that Ebola is something that as healthcare professionals our readers will have a unique perspective on, and so maybe it’s worth discussing. As a professional in any field it’s always interesting, and often frustrating when a story that has to do with the specifics of your field breaks into the mainstream news cycle. Things tend to get twisted, distorted, elided, or just plain mixed up. Yet, at the same time there is a real story here. Ebola is real, and it is scary, and we should care about it, but how can we interact with others about it in a way that is professional, helpful, and insightful?

This is a question we imagine a lot of healthcare professionals have. Whether it’s browsing your Facebook feed or reading the op-eds, a conversation with a neighbor or an invitation to speak at a conference, chances are you are aware of both the situation and certain mischaracterizations of the situation. So, have you responded? Which concerns you most? Here are a few that we think are among the most common unhelpful responses: [Read more →]

New Study Shows that Malpractice Reform has Little Impact… Or Does It?

Malpractice Reform, little impact?A new study published by the Rand Corporation in the New England Journal of Medicine has many in the media aflutter with fresh pronouncements that reducing physicians’ risk of being sued doesn’t reduce defensive medicine and doesn’t save money. The study purports to show that in three states where reform was enacted certain variables, taken as indicators of defensive medicine, did not change substantially. But let’s look a little closer.

The study looked at over three million Medicare patients over the period from 1997 to 2011. Researches looked specifically at emergency room visits and measured three variables: the number of CT scans and MRIs ordered, the rate at which patients were checked into the hospital following their ER visit, and total charges for the ER visits. What they found was that in three states that changed their standard for emergency care from ordinary negligence (failure to exercise a reasonable standard of care) to gross negligence (knowingly failing to exercise a reasonable standard of care), Georgia (2005), South Carolina (2005), and Texas (2003), there was no appreciable difference in the rate of advanced imaging or inpatient check-ins, and that only in Georgia was there a very small decrease in costs. The study’s author, Dr. Daniel A. Waxman, concluded that, “This study suggests that even when the risk of being sued for malpractice decreases, the path of least resistance still may favor resource-intensive care, at least in hospital emergency departments.” But does it?

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The 6 Keys to IT Security

IT SecurityWe here at eQuoteMD had the opportunity this week to attend a HIPAA Workshop in St. Louis, Missouri sponsored by the Keane Insurance Group, Keystone IT Consulting, and the Sandberg Phoenix & Von Gontard law firm. The focus of this workshop was IT Security, specifically as it applies to the healthcare industry in light of HIPAA and other regulatory laws. While IT can seem daunting to those outside the field with all the tech talk and the ever changing technology, it’s important for doctors and/or their office managers to get a handle on what is necessary to achieve compliance. We’re now in an era where it’s simply not enough to install a firewall and a virus blocker and hope nothing happens. The rules have changed, and audits are happening with greater frequency than ever. Perhaps more importantly though, with the widespread adoption of electronic protected health information (ePHI), practices have a greater obligation than ever to ensure their patients’ privacy and the protection of their data.

In some cases this may mean getting educated yourself, but often it will also mean partnering with someone that can shepherd you through the process of becoming and remaining compliant. IT security professionals make it their business to keep up with the two moving targets that form the twin focus of IT security: public policy and technology. And it was from those two perspectives that our workshop presenter spoke as he educated us on some of the crucial elements of IT security for a medical practice.

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