Oklahoma first passed reforms in 2003 through the Affordable Access to Healthcare Act, or SB 629, which was designed to improve the availability of healthcare services, lower the cost of medical malpractice insurance, ensure fair compensation for legitimate claims and improve the cost-effectiveness of the stateâ€™s medical liability system. The bill included a $350,000 cap on noneconomic damages for obstetric and emergency room cases, as those two specialties are most frequently associated with costly adverse medical events and therefore pay the highest premiums. The law also required that the plaintiff present an affidavit from a qualified expert stating he or she believes negligence occurred. The affidavit requirement was overturned by the Oklahoma Supreme Court in a 2006 ruling, as it was judged the affidavit requirement to be a â€śspecial law,â€ť which is prohibited by the Oklahoma constitution, which does not allow one type of negligence case (medical malpractice) to be treated differently than all other negligence cases. In 2008, the noneconomic damage cap was overturned for similar reasoning, as the court noted it only applied to certain torts.
In 2009, Oklahoma passed the Comprehensive Lawsuit Reform Act, which sought to restore some of the earlier provisions, as well as institute new reforms. The new law set a noneconomic damage cap of $400,000 for medical malpractice cases (except in cases deemed â€śexceptional circumstancesâ€ť) and reinstated the certificate of merit requirement (now for all civil liability cases). In 2011, the legislature strengthened the noneconomic cap, setting it at $350,000 and only allowing it to be pierced if the defendant acted in reckless disregard of the rights of others or acted with gross negligence, fraudulently and/or with intentional malice.
In 2013, the Comprehensive Lawsuit Reform Act was overturned as violating the single-subject rule in the Oklahoma Constitution. In legal terms, this is known as â€ślogrolling,â€ť meaning to pass a bill with multiple unrelated subjects. However, the $350,000 cap on noneconomic damages was not included in this ruling, as the Oklahoma Supreme Court judged that the 2011 amendment to the cap had made that part of the act constitutional.