Medical malpractice insurance is expensive in Rhode Island. Base rate premiums start above the $100,000 mark for high-risk specialties like obstetrics, neurosurgery and orthopedic surgery on the spine; specialties that carry more-moderate risk suffer base rate premiums that are three-times higher than states with a more enviable liability climate.
The high cost of medical malpractice insurance in Rhode Island can be directly attributed to the existing laws that govern its system of civil litigation. As recently as 2010, Pacific Research Institute ranked Rhode Island as the state with the “worst tort laws in the United States.” In another report by the free-market think tank, Pacific Research Institute ranked Rhode Island as one the states with the worst medical tort laws on the books.
According to the Pacific Research Institute’s “U.S. Index of Health Ownership” survey of medical tort laws, liability laws drive medical-tort costs, which increase healthcare costs. The study ranks the health of individual states’ medical torts based on eight variables:
1. The ratio of medical-malpractice insurance losses per projected personal health expenditures in the state.
2. Whether the state has a cap on non-economic damages or increased the negligence standard required for medical malpractice.
3. Whether the state has a cap on punitive-damage awards in medical-malpractice lawsuits.
4. Whether the state sets attorney-fee limits for medical-malpractice cases.
5. Whether the state allows for pre-trial screening or arbitration in medical-malpractice cases.
6. Whether the state allows a “Food and Drug Administration (FDA) defense” or a “Federal Trade Commission (FTC) defense,” which gives some immunity if the FDA has approved the therapeutic product or the FTC has approved its advertising.
7. Whether the state has conditions on the use of expert witnesses in medical-malpractice lawsuits.
8. Whether the state has a statute of limitations on medical-malpractice cases.
With this kind of negative attention being showered on its civil justice system generally, and its laws dictating the handling of medical liability claims in particular, one would expect medical professional liability tort reform to be high on its state government’s priority list. Unfortunately, that has not been the case.
The only existing medical liability tort reform on the books in Rhode Island is one that permits the admissibility of evidence collateral source payments from state income disability or workers’ compensation as well as any health, sickness or income disability policy for reimbursement. It requires a jury to reduce damage awards by the amount paid by collateral sources, if such evidence is introduced. In other words, if a negative healthcare outcome forces a patient to go on disability, and that patient successfully sues his physician for the economic losses he incurred from being unable to work, the disability income that patient has been receiving must be subtracted from the final monetary award.
The last time Rhode Island made a major push to pass medical liability tort reform was in 2006 when then-Gov. Donald Carcieri urged lawmakers to support his Health Care Tort Reform Act, which he promised would bring balance to the state’s tort system. At the time, the American Medical Association had named Rhode Island as one of 21 states suffering a medical liability crisis.
In the years leading up to Gov. Carcieri’s push to pass the Health Care Reform Act, Rhode Island medical malpractice insurance premiums had been increasing 40- to 100-percent annually, forcing physicians to retire early or move to another state for malpractice insurance relief. The bill would have reduced the statute of limitations on medical liability claims from three years to two; required a timely disclosure of expert testimony; cap non-economic damages at $250,000; limited the amount of attorneys’ fees that can be collected; established a pre-trial screening mechanism at the outset of the claim to determine if the case has merit; and changed the rules on prejudgment interest to discourage plaintiffs from waiting for years before filing a claim.
Unfortunately for the Rhode Island healthcare community, Gov. Carcieri’s tort reform legislation never made it to his desk to sign into law.
It is unlikely medical malpractice rates will significantly shrink in the near future. This is why it is critical to a physician’s business success that he or she work with an experienced medical malpractice insurance broker when looking for coverage. Only an experienced broker with access to all the major carriers in the state will be able to shop your coverage for the best terms at the most affordable rates. Request your free quote today.
This write-up of Rhode Island was put together by Michael Matray, the Editor of the Medical Liability Monitor