Tag Archives: California

Consumer Group, Plaintiff Attorneys Want California Voters to Overturn MICRA Cap

Since 1975, California’s Medical Injury Compensation Reform Act (MICRA) has been the golden standard of medical liability tort reforms. Signed into law during the nation’s first medical malpractice insurance premium crisis, MICRA instituted a cap of $250,000 on non-economic (pain-and-suffering) damages, capped the percentage of an award available for attorney fees, shortened the statute of limitations for medical liability claims and allowed physicians found negligent to pay awards off in periodic payments. Proponents of MICRA consider the $250,000 cap on non-economic damages, which is not indexed for inflation, the most crucial component of the law for keeping medical professional liability insurance premiums reasonable in the state.

Since its enactment, the California Plaintiffs Bar has tried to have it either overturned as unconstitutional through the courts or eliminated legislatively. Neither strategy has proven successful. In 1985, the California Supreme Court upheld the constitutionality of MICRA, and there has not been enough political will in the California Legislature for tampering with the Act.

Now opponents of MICRA are gearing up to get a ballot initiative in front of California voters in the November 2014 elections. Specifically, they want to raise the non-economic damage cap to $1.1 million, where they say it would be if the 1975 cap were to be adjusted for inflation. According to the consumer-advocacy group Consumer Watchdog, the $250,000 cap in 1975, when considering inflation, would only be $58,000 in today’s currency.

Those opposing the MICRA cap argue that it is keeping legitimately harmed patients from their day in court. They say that medical professional liability insurers know that with most cases, if they go to trial, the largest damage they could incur would be $250,000. Because plaintiff attorneys work on contingency, and a medical malpractice trial is expensive, even if they were to prove their case, there would not be enough money to cover their expenses.

Consumer Watchdog is spearheading the signature drive for getting the initiative on the ballot. The group will begin gathering the signatures in September of this year, and they need the signatures of 400,000 registered voters to succeed.

California Medical Liability Insurance Rates Reduced Again

On June 11, the California Department of Insurance announced that it was flexing its rate regulation authority by mandating the state’s largest insurer of medical liability decrease its California medical malpractice insurance rates by an average of 10 percent. The Doctors Company now joins MIEC, MedPro, NORCAL Mutual, The Dentists Insurance Company and NCMIC in having its rates cut by Commissioner Dave Jones.

According to the California Department of Insurance, the forced rate reduction will save doctors insured by the The Doctors Company a total of $21 million. Combined with the rate reductions imposed on the other five professional liability insurance companies, the total savings will amount to $44 million.

Last year, California Insurance Commissioner Jones required the top six medical liability insurance companies in the state to submit and justify rate filings.

The Commissioner Jones has gone about the business of reigning in California medical liability insurance rates in dramatic fashion, dripping the results of its rate inquiry – and the resulting rate reductions – in three phases. The first rate reductions were announced in early March; the second round in April; and the announcement on The Doctors Company came this week (June 11).

The “drumroll please” method of announcing medical liability insurance rate reductions has been played for maximum political effect, and the press releases announcing the rate reductions have barely concealed what many in the industry believe to be California Insurance Commissioner Jones’s endgame, which is to get similar rate regulating authority over California’s healthcare insurance companies.

Each press release has lamented the fact that Jones does not have similar authority to regulate California’s healthcare insurance rates, and each press release announces that Proposition 103 will be a ballot initiative come the November elections. Proposition 103, if passed, will give Jones the authority to regulate California’s healthcare insurance rates.

More than Half of All Medical Malpractice Indemnity Payments Were Made by Six States

A recently released study of all medical malpractice payments made in 2011 indicates that six states accounted for more than half of all medical malpractice indemnifications. The analyzed data came from the National Practitioner Data Bank

That is an astonishing statistic. Which six states accounted for more than half of all medical malpractice indemnity payments is not a surprise. The highest malpractice payout was New York, followed by Pennsylvania, Illinois, New Jersey, Florida and California.

Not coincidentally, the states with the highest medical malpractice indemnity payments also have some of the highest medical malpractice insurance premiums. In some parts of New York and Florida, an obstetrician can be paying in excess of $200,000 in annual base rate medical liability premium.

Looking at base rate premiums in California, one can see how tort reform can keep medical malpractice insurance premiums affordable. While California paid out the sixth largest dollar total in medical liability indemnity, its medical malpractice insurance rates are comparatively inexpensive. An obstetrician practicing in the state’s most expensive county (Los Angeles County) for medical malpractice insurance can pay as little as $38,050 in base rate premium. The most expensive annual base rate premium in Los Angeles County hovers around $80,000. Compared to New York and Florida, those numbers are a steal.

The California Medical Injury Compensation Reform Act (MICRA) has long been the gold standard in medical liability tort reform. Enacted in 1975, the law caps non-economic, pain-and-suffering damages at $250,000. The law also has other requirements that are intended to weed out frivolous lawsuits.

Other interesting statistics found in the study of 2011 medical malpractice payments include:

• The six states that make up the bottom of the malpractice indemnity payments (South Dakota, Vermont, Wyoming, North Dakota and Alaska) make up less than 1 percent of of total payouts.

• Slightly more than 36 percent of all medical malpractice indemnity payments are made to patients age 40 to 59 ($1.3 billion) , followed by patients age 20 to 30 ($786.3 million).

• In total, 58 percent of all medical malpractice indemnity payments were made to women; 42 percent of all indemnity payments were made to men.

• Medical malpractice indemnity payments have been declining since 2003.

• The total dollar amount of 2011 medical malpractice indemnity payments were slightly less than they were in 2010.

California Mandates 3 Medical Malpractice Insurers Reduce Rates

California insurance commissioner Dave Jones recently mandated lower rates for medical professional liability insurance offered by NORCAL Mutual Insurance, the Dentists Insurance Company and the MIEC Physicians & Surgeons program.

Last year, Jones asked California’s top six medical malpractice insurance companies to submit rate filings to the Department of Insurance and justify their current rates. After review of those filings, the department required NORCAL Mutual to reduce its rates by 7.07 percent, saving its insureds $9.65 million. The Dentists Insurance Company reduced its rates by 13.42 percent, saving its insureds nearly $4 million, and MIEC reduced its rates by 19 percent, saving its insureds $5.3 million. According to Jones, doctors, dentists and other medical providers insured by these companies will save nearly $19 million annually in premiums following the rate reduction. Premiums from the other three companies asked to submit rates are still under review by the department.

Jones’ authority to regulate medical malpractice insurance rates stems from the passage of Prop 103 on Nov. 8, 1988. The ballot initiative gave the elected insurance commissioner the authority to approve property and casualty rates before they go into effect.

Advocates for the repeal of California’s non-economic damage cap have jumped on the Prop 103 bandwagon. They have come out vocally in support of the insurance commissioner’s power to regulate insurance, calling Jones’s flexing of his authority more effective at reducing medical malpractice insurance premiums than California’s MICRA Act, which has long been considered the gold standard of medical malpractice tort reforms. At the heart of MICRA is a $250,000 cap on non-economic damages. According to those advocating the repeal of the state’s non-economic damage cap, 13 years after the passage of MICRA and its non-economic damage cap, medical malpractice insurance rates had grown by 450 percent; three years after the passage of Prop 103, which allows for greater regulation of the medical malpractice insurance industry, medical malpractice insurance premiums had shrunk by 20 percent.

Some in the industry have argued that Jones’ call for rate reductions is political in nature. He has gone on record in support of Assembly Bill 52, which would also grant the insurance commissioner the ability to regulate healthcare insurance rates. Assembly Bill 52 is currently being considered in the California S

Computer with Information on 4 Million Patients Stolen in California

side note: Today’s healthcare industry is increasingly dependent on computers and data sharing via the internet or an intranet system. Add to this the increasingly common use of social networking services, like Facebook, as a means of marketing a medical practice to potential patient customers. This evolution toward cyber-dependency has been accelerated by the Patient Protection & Affordable Care Act, which mandates the use of portable electronic medical records as a means of cutting healthcare costs.

The pressure on the healthcare community to protect the integrity of patient data has never been greater, and there has been a significant increase in the number of lawsuits tied to reports of data breaches and accidental releases of sensitive medical or financial information. These breaches can be considered a major violation of HIPPA rules in regard to patient privacy.

Many major medical malpractice insurance companies are offering a cyber liability coverage product to policyholders. Oftentimes, this additional coverage can be acquired at little or no expense.

In regard to social networking platforms, it is a smart idea to have a frank conversation with a your staff about what is and what is not permissible to post as well as when it is appropriate to post. It is an even smarter idea to draft an internet policy for you and your staff.

Cyberliability is a new medical liability risk. If you are not sure if you and your staff are engaging in the most safe cyber practices, contact your broker or medical malpractice insurance company and ask them if your practices are compliant.

A Northern California physicians network says a computer stolen last month contains personal information on more than 4 million patients dating back to 1995.

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Insurance Reform Needed to Lower New York Doctors' Medical Malpractice Rates, California Consumer Watchdog Testifies

side note: California has long been on the cutting edge of medical liability tort reform. It was the first state in the nation to institute a cap on non-economic damages with the 1975 Medical Injury Compensation Reform Act (MICRA) of 1975. The cap helped California stabilize liability costs, particularly for specialty and high-risk services such as women’s healthcare, community clinics, health centers and rural providers who can least afford skyrocketing insurance costs.

MICRA was strengthened with the passage of Proposition 103 in 1988. Prop 103 mandated that every insurer reduce its rates by 20 percent, unless such rollback would lead to a company’s insolvency. It also mandated changes in property-and-casualty insurance (medical malpractice insurance) rates had to be approved by the insurance commissioner.

Prior to Prop 103, insurance companies were not required to file rates for approval except for health and life. Essentially, only competition regulated the marketplace, and many thought that the insurance companies were in collusion in their attempt to inflate rates. Due to Prop 103, Rate Filing Bureaus were created in the Rate Regulation Division to implement the following provisions of Proposition 103.

The following article details how one of the authors of Prop 103 recently testified in New York on how this form of rate regulation is crucial to getting a grip on the state’s out-of-control medical malpractice insurancepremiums.

NEW YORK, Oct. 27, 2011 /PRNewswire-USNewswire/ — The author of California’s insurance regulatory reform…… (continue reading)

California's $250,000 Cap on Non-Economic Damages in Malpractice Cases Upheld

side note: Since 1975, California’s MICRA Tort Reforms, which include a $250,000 cap on non-economic damages, has been the gold standard of tort reforms for more than 35 years. It has been tested in the state’s court system regularly, and most recently, an appellate court decision that reduced a $6 million jury award to the state’s limit of $250,000, stands as another affirmation of the law’s constitutionality. California’s relatively moderate medical malpractice insurance premiums are often attributed to the MICRA Act.

By ALICIA GALLEGOS, amednews staff. Posted Sept. 26, 2011.

The Court of Appeal of the State of California, 5th Appellate District, has upheld the state’s $250,000 noneconomic damages cap, reaffirming what physicians nationwide consider the gold standard among tort reforms.

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Avoidable Medical Errors a Danger to Patients, Doctors and Hospitals

Side note: California is taking steps to deal with so-called ‘never events’ at the state’s hospitals. A particular problem is accidentally leaving surgical instruments and materials inside a patient after completion of surgery. In an effort to reduce the number of these errors, California has been fining hospitals for their mistakes, collecting nearly $300,000 in fines since 2007. The state will be using $800,000 of this money for research to help hospitals improve their practices so that they can avoid this type of medical error.

Though a medical malpractice lawsuit is not automatic when these types of errors occur, it is important for physicians and surgical teams to know how to avoid them. The research being funded in California is an important step – leading, perhaps, to new procedures that can help avoid medical error, malpractice claims, and the spiraling medmal insurance premiums surgeons and other specialists often face.

Victoria Colliver, Chronicle Staff Writer
San Francisco Chronicle

Drill bits, screws, sponges, clamps, needles, catheters, electrodes. These are some of the things accidentally left inside patients after surgery at California hospitals.

Read the full article over at the San Francisco Gate

California medical malpractice damages cap in malpractice cases an issue

side note: Some in the California Legislature are arguing that language in the proposed Affordable Care Act would encourage the state to overturn its MICRA non-economic damage cap.

One of the many contentious issues in the national health care debate is something that began 34 years ago in California when Jerry Brown, in the first year of his first governorship, signed legislation imposing a $250,000 limit on pain and suffering damages in medical malpractice cases.

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Appellate court upholds California medical liability cap

side note: California Court Upholds Medical Malpractice Liability Cap, Good Sign for State’s Malpractice Insurance Rates: California’s $250,000 cap on non-economic damages in medical malpractice cases recently withstood its first appellate court challenge in more than 20 years. The 5th Appellate District Court ruled that the limit set with the state’s Medical Injury Compensation Reform Act (MICRA) of 1975 is constitutional and does not infringe upon a jury’s right to determine just compensation. The ruling is good news for the state’s long-stable insurance rates.

By Tanya Albert Henry
AMNews

California’s $250,000 non-economic damages cap in medical liability lawsuits is intact after withstanding its first constitutional challenge at the appellate court level in more than two decades.

The Court of Appeal of the State of California, 5th Appellate District ruled that the dollar limit set under the state’s 1975 Medical Injury Compensation Reform Act, or MICRA, is constitutional and doesn’t infringe on a jury’s power. The three-judge panel also rejected an argument that the cap violates a plaintiff’s rights because the maximum $250,000 allowed under the law doesn’t give plaintiffs the same buying power today as it did in 1975.

The decision in Van Buren v. Evans reaffirmed state Supreme Court rulings from the 1980s that said the Legislature had the right to limit damages as a way to curb doctors’ insurance costs so they could stay in business and treat patients.

Lawmakers passed MICRA at the height of a state medical liability crisis. Physicians nationwide view California reforms as the gold standard in tort reform. Continue reading