December 12, 2024 by matray

Below are some headlines and article synopses from the December 2024 issue of Medical Liability Monitor. To read the articles in their entirety, please subscribe today.

How the 2024 Elections Could Affect the MPL Insurance Industry
Elections have consequences. And with the 2024 U.S. election cycle in the American rearview mirror, industry leaders are doing their best to decipher what those consequences — good or bad — might be for their business. With unified Republican control of the executive and legislative branches of government, will the GOP agenda be able to tame the economic inflation — much less social inflation — that is challenging the medical professional liability industry’s claims and operations costs? Is the Holy Grail of passing federal damage caps finally a possibility? And what were the outcomes of key races for governorships and state legislatures, where most medical liability reforms are typically enacted? …

New Mexico Jury Awards Record $412 Million Medical Liability Verdict
A New Mexico jury awarded more than $412 million last month to a man in a medical malpractice case involving NuMale Medical, a national chain of men’s health clinics. According to the plaintiff’s attorneys, it is the largest amount ever awarded by a jury for a medical malpractice claim in the United States …

DWP, Investment Gains Offsetting Underwriting Difficulties for MPL Specialty Writers
Direct written premium and investment income continued to rise during the third quarter of 2024, insulating the industry from continued underwriting losses …

Report on Digital Health Services Highlights Insurance Coverage Gaps
Digital health services are rapidly augmenting how healthcare is delivered in the United States. A new white paper, 2024 Digital Health Insurance Report, shares insights from medical professional liability insurance agents surveyed about the risks associated with using digital health services and how their clients are contemplating insurance coverage for these exposures …

Michigan Supreme Court Asked to Weigh Constitutionality of Medical Liability Damage Caps
The U.S. District Court for the Eastern District of Michigan last month requested that the Michigan Supreme Court certify legal questions regarding the constitutionality of the state’s cap on noneconomic damages in medical liability lawsuits …

Iowa Supreme Court Reverses, Remands State’s Largest Medical Malpractice Verdict
The Iowa Supreme Court last month reversed and remanded a $97.4 million medical liability verdict from 2022 — the largest of its kind in state history — for a violation of the hearsay rule. This decision paves the way for a new trial …

Ambiguous Abortion Bans Fueling New ‘Hesitant Medicine’
Abortion bans are intended to reduce elective abortions, but they also affect the way physicians practice medicine. Key finding from a recently published article in the journal Social Science & Medicine finds that abortion bans with criminal penalties are driving the new phenomenon of “hesitant medicine,” where providers are forced to prioritize their own criminal legal risks over the well-being of their patients and hesitate to provide the treatment their patients require …

Subscribe today to get this issue (as well as the 2024 and 2025 Annual Rate Survey at no additional cost).

December 6, 2024 by matray

MagMutual Insurance Co. announced that its chief medical officer Tanner Colegrove, MD, will present current research on maternal mortality in the U.S. during the American College of Obstetricians & Gynecologists (ACOG) West Virginia Section Meeting, December 6 - 8 at the Greenbrier in White Sulphur Springs.

Colegrove will discuss findings from MagMutual’s report Worsening Maternal Mortality in the U.S.: The Role of Physicians and the Public in Addressing this Growing Crisis, which examines the many causes driving the maternal mortality trend and provides strategies for healthcare providers to elevate care, improve outcomes and reduce litigation.

Dara Aliff, DO, a member of the MagMutual Board of Directors, is chairing the ACOG program, which is eligible for CME credit. Participating faculty will lecture on issues, clinical developments and diagnostic and treatment methodologies in obstetrics and gynecology, including maternal morbidity and mortality, minimally invasive gynecological surgery (MIGS) in pregnancy, adolescent contraception, polycystic ovary syndrome (PCOS), preterm birth prediction, and prevention, menopause and fetal surgery.

“Maternal mortality in the U.S. is an incredibly complex issue which requires the collective involvement of the medical community, legislators, researchers, educators and the general public,” Colegrove said. “MagMutual has conducted extensive research on this issue, and I’m gratified to share the findings that may help the medical community have a meaningful impact in addressing this problem beyond their own healthcare institutions.”  

December 3, 2024 by matray

AM Best affirmed BETA Healthcare Group’s financial strength rating of “A” (Excellent) with a stable outlook. BETA is a provider of hospital professional liability and the medical professional liability.

Best noted several key aspects of BETA’s operations that contributed to its rating:

• Strongest level of risk-adjusted capitalization as measured by Best’s Capital Adequacy Ratio (BCAR)

• Prudent loss reserving practices which have resulted in consistently favorable development of prior accident year reserves

• Long-term history of organic surplus growth despite sizable dividends paid annually, which are used to manage capital and return profits to members

• Sound liquidity measures supported by an invested asset base that predominantly consists of high-quality fixed-income securities that generate consistent and growing net investment income

“We are pleased that AM Best once again gives BETA high marks for its financial strength and operational excellence,” said Corey Grove, CEO of BETA Healthcare Group. “We continue to build upon this solid foundation to not only be there when our members need us financially, but also help advance their efforts to develop safety cultures and the infrastructure to embed the principles of both patient and employee safety in their organizations.”

November 13, 2024 by matray

Admiral Insurance Group, a Berkley Company providing wholesale-dedicated excess and surplus (E&S) lines commercial insurance, announced the company will be adding virtual care to its primary and excess professional liability products.

The rapidly evolving field of specialized technology services and products designed to assist healthcare providers has created a gap between medical malpractice and technology errors and omissions (E&O) insurance policies. As a result, there is a growing demand for insurance products that will effectively address the unique risks associated with these advancements.

"As technology is ever evolving, especially in the medical field, so are the associated risks," stated Nir Gabay, senior vice president, head of professional liability at Admiral. "We're excited to now be offering our Virtual Care coverage that addresses those unique risks with comprehensive solutions."

Virtual care coverage will be offered exclusively through Admiral's nationwide network of wholesale brokers. The policy offers primary and excess limits up to $5 million, encompassing a comprehensive range of coverages, including medical malpractice, technology errors and omissions (E&O), media liability and a full suite of cyber coverages, all within a single policy.

According to Admiral, it embraces a diverse range of specialized classes by leveraging their extensive experience in delivering high-quality professional liability insurance solutions designed for medical and technology professionals. Their virtual care coverage sample classes include custom healthcare software development and licensing, remote patient monitoring technology, teleradiology services and healthcare technology consulting, to name a few.

November 12, 2024 by matray

Preverity, a provider of risk management and patient safety solutions for the healthcare industry, announced today that its wholly owned subsidiary, Preverity PSO, has been listed as a Patient Safety Organization (PSO) by the Agency for Healthcare Research and Quality, effective September 6, 2024.

PSOs, established by the Patient Safety and Quality Improvement Act of 2005, play a crucial role in supporting healthcare providers in their efforts to enhance patient safety and healthcare quality. They foster a culture of safety by providing valuable resources, data analysis, and confidential reporting mechanisms.

Preverity's decision to pursue PSO listing stemmed from recognizing the growing demand for specialized patient safety and quality improvement information among its partners and clients. The company's extensive experience in risk management, coupled with its comprehensive database of over 80 percent of U.S. physicians, enables it to uniquely quantify the relationship between clinical activity and patient safety risk. Preverity PSO will provide actionable insights to support healthcare providers in executing a safe, high reliability clinical program.

Preverity PSO's unique capabilities include national patient safety benchmarking data to alert providers of potential areas where they may face an elevated risk of safety concerns. This proactive approach empowers providers to address potential issues before they escalate, ultimately contributing to improved patient outcomes.

"We are thrilled to be recognized as a Patient Safety Organization by AHRQ," said Gene Boerger, Preverity PSO Executive Director. "This designation underscores our unwavering commitment to enhancing patient safety and quality improvement."

Preverity PSO will serve direct providers and health systems. The company's comprehensive database, containing medical billing history, provider transactions, and education offers insights into healthcare provider performance and risk profiles. This database and other resources will help Preverity PSO play a key role in advancing patient safety and supporting healthcare providers in delivering safe, high-quality care.

November 12, 2024 by matray

PIB Group Ltd (‘PIB’ or ‘the Group’), a specialist insurance intermediary, has entered the French market with the strategic acquisition of a prominent French medical malpractice insurance business BEA Group and its subsidiaries.

This investment marks a significant milestone in PIB Group’s ongoing European expansion and establishes a strong platform for further growth in France and beyond.

BEA Group is a French group founded in 2009 by CEO Marco Favale. It operates in the brokerage and claim management sector, focusing on medical malpractice and public market players. BEA Group has nine offices in three locations and also operates in the Italian market, through the 2023 acquisition of Capanna. The deal will see PIB Group providing investment and support to the BEA Group team, allowing them to continue growth across France and Italy.

The French market presents a substantial opportunity for PIB Group to enhance its European presence and offer specialized insurance solutions to a broader clientele. The newly acquired business, renowned for its expertise in medical malpractice, is well positioned to capitalize on the increasing demand for such insurance products across the continent.

With backing from world-leading private equity firms, Apax Funds and The Carlyle Group, this investment is a crucial step in realizing the strategy for PIB Group, consolidating specialist insurance distribution across major European markets.

Brendan McManus, CEO of PIB Group, stated, "Our deal with BEA Group is a significant achievement for the whole PIB Group, marking our 100th investment. France has long been a key missing link in our European growth strategy and I’m proud that we’ve been able to secure such a strong foothold in this critically important market. BEA Group is an entrepreneurial company, with exceptional people who have built an incredible brand and loyal customer base across France and Italy.

"I want to give a very warm welcome to Marco and Alexandre and everyone at BEA Group. Together, we’ll ensure our new colleagues settle well into the PIB family and work closely to ensure that we respect the nuances of the French and Italian markets. Our goal is to blend our international expertise with their deep local knowledge to create a thriving business that benefits everyone.”

Onno Jansen, CEO for PIB Group Europe, commented: “Our investment with BEA Group is one of the most exciting and important deals we’ve done to date. It not only strengthens our position in Europe but also sets the stage for future growth and innovation - much of which will occur in France and Italy. As we continue to pursue our strategy of consolidation and expansion across Europe, this deal is a testament to the team’s commitment to delivering specialised insurance solutions that meet the evolving needs of clients.”

Marco Favale, CEO and founder BEA, commented: “We’ve seen considerable growth at BEA Group over the past few years as we’ve worked to become a leading player in the medical malpractice space. Joining PIB Group for us marks the next stage of our journey, taking all that we’ve built so far and accelerating that growth using PIB Group’s resources and investment. It’s an incredibly exciting time for our team and clients, and we’re looking forward to a bright future ahead in France and Italy.”

November 7, 2024 by matray

by Margaret Surowka, Esq.
Being disciplined by a state medical board is one of the most daunting experiences a physician can face, with far-reaching consequences such as the loss of insurance plan participation, credentialing issues and even the revocation of board certification. The complexity of such disciplinary actions is heightened when physicians hold licenses in multiple states. Even if a physician's license in a particular state is inactive and they haven't practiced there for years, that state may still impose disciplinary actions based on findings from another jurisdiction. Since professional discipline is governed individually by each state, physicians with licenses in multiple states must remain aware of the potential issues and know how best to defend both themselves and their licenses.

The New York State Office of Profes-sional Medical Conduct, for example, considers any discipline or criminal conviction in another state as grounds for its own disciplinary action. Moving out of state does not necessarily mean escaping New York’s jurisdiction. If a physician holds a New York license — even if inactive — a disciplinary action in another state could result in the revocation or suspension of their New York medical license, regardless of where they currently practice.

Under New York Education Law §6539(9)(d), if a physician faces disciplinary action, license revocation or suspension in another state for conduct that would qualify as professional misconduct in New York, they risk losing or having their New York license suspended, even if it’s inactive.

It is critical for physicians to take prompt steps to avoid disciplinary action in New York, even if they no longer live or practice there. While New York typically initiates charges only when a violation is reported or discovered, physicians should remain vigilant about monitoring their status to prevent potential repercussions. Even if the disciplinary action in another state is relatively minor — such as a requirment to attend continuing medical education classes or pay fines — physicians could face more severe penalties in New York, especially if they fail to respond promptly.

A recent example, published on the New York Department of Health website, involved a doctor disciplined by the New Mexico Medical Board. The physician was required to complete a controlled substances course, submit a summary to the board and undergo a psychological evaluation but was allowed to retain his license. However, when the New York board attempted to notify him of the disciplinary action, they were unable to reach him. As a result, he missed the opportunity to defend himself, and the New York board ultimately revoked his license.

This case underscores the importance of staying proactive and responsive. While physicians may be able to negotiate less severe disciplinary actions in other states — such as by completing educational courses or evaluations — failure to address the matter in New York can lead to severe consequences. A license revocation in New York can negatively impact medical liability insurance costs and will be publicly listed in the National Practitioner Data Bank, damaging a physician’s reputation and professional opportunities. Therefore, it is essential for physicians to remain reachable and responsive to avoid such outcomes.

This example is not an isolated incident. In fact, four out of the last 10 published decisions on the New York Department of Health website resulted from disciplinary actions originating outside of New York.

Physicians licensed in New York should also be aware that while they have the right to a hearing in cases of disciplinary action, the scope of that hearing is limited. Physicians cannot relitigate the underlying issues that led to the initial disciplinary action in the originating state. Instead, the hearing in New York typically focuses solely on determining the appropriate penalty. This limitation can make the defense process more challenging, as the original misconduct will not be reconsidered even if the penalties in New York could be severe.

Furthermore, New York often imposes onerous conditions if an agreement from a consent order is reached before any hearing. These conditions may include requiring the physician to reactivate their license, thereby preventing them from placing their license in inactive status. This would also require biennial registration fees from doctors who no longer practice in the state.

In summary, if you hold medical licenses in multiple states, it is essential to understand how each state you have been licensed in may take action against you for discipline imposed by the state where you actively practice. Ensure your contact information is updated in all states where you hold — or have held — a license, and always be responsive to notices from other states. Lastly, engage experienced legal counsel in the disciplining state to advise and defend you should the need arise.

Margaret Surowka is an attorney at Barclay Damon LLP, where she serves as co-leader of the firm’s Health & Human Services Providers Team. Her practice includes representing agencies, facilities and individual providers in compliance matters as well as licensure, disciplinary and ethics proceedings.

November 7, 2024 by matray

Below are some headlines and article synopses from the November 2024 issue of Medical Liability Monitor. To read the articles in their entirety, please subscribe today.

Pennsylvania Lawmakers Respond to Medical Liability Crisis
Medical liability tort reform advocates applauded Pennsylvania lawmakers last month when they introduced a package of tort reform bills aimed at addressing the commonwealth’s lawsuit crisis. The Pennsylvania court system consistently ranks among the most plaintiff-friendly, and the Supreme Court of Pennsylvania and Philadelphia Court of Common Pleas were declared the nation’s worst Judicial Hellholes for 2023/2024 by the American Tort Reform Foundation (ATRF) …

Artificial Intelligence Enabled Cameras Prevent Medication Errors
A team of researchers has developed the first wearable camera system that detects potential errors in medication delivery via artificial intelligence (AI) technology. In a test reported in npj Digital Medicine last month, the camera system recognized and identified which medications were being drawn in busy clinical settings with high proficiency. The AI technology achieved 99.6% sensitivity and 98.8% specificity at detecting vial-swap errors …

Colorado Supreme Court to Investigate How Damage Cap Can Be Pierced
The Colorado Supreme Court recently agreed to review a medical liability case involving an almost $40 million judgment against Banner Health, specifically to investigate the legal standard for determining damages when the trial court determines the state's $1 million cap on total medical malpractice damages can be exceeded. Colorado’s Health Care Availability Act currently enforces a $1 million total cap on combined economic and noneconomic damages for medical liability lawsuits. However, the total cap can be pierced when, “upon good cause shown,” the court “determines that the present value of past and future economic damages would exceed such limitation and that the application of such limitation would be unfair”…

Think Tank Prescribes Medical Malpractice Act Revisions to Solve New Mexico’s Healthcare Worker Shortage
Think New Mexico, a 501(c)(3) think tank committed to improving the lives of New Mexicans, published a policy report last month making a series of recommendations to alleviate the state’s healthcare worker shortage. To address the high cost of medical liability insurance coverage that “discourages providers from locating [to New Mexico], and drives others away,” the Think New Mexico policy report recommends six reforms to the state’s Medical Malpractice Act …

Coverys Report Examines Drivers of Diagnostic Error in the ED
Coverys published its latest Dose of Insight report last month, providing a data-driven look at the drivers of diagnostic error. Diagnostic error contributed to 26% of all Coverys medical liability claims from 2019 through 2023 yet represented 41% of the total indemnity paid over the same period. These claims had an average indemnity of $627,000 per claim, almost 50% more expensive than the average indemnity for all other types of malpractice events …

Physicians With Multiple State Licenses Face Complex Disciplinary Risks
Being disciplined by a state medical board is one of the most daunting experiences a physician can face, with far-reaching consequences such as the loss of insurance plan participation, credentialing issues and even the revocation of board certification. The complexity of such disciplinary actions is heightened when physicians hold licenses in multiple states. Even if a physician’s license in a particular state is inactive and they haven't practiced there for years, that state may still impose disciplinary actions based on findings from another jurisdiction. Since professional discipline is governed individually by each state, physicians with licenses in multiple states must remain aware of the potential issues and know how best to defend both themselves and their licenses …

Subscribe today to get this issue (as well as the 2024 and 2025 Annual Rate Survey at no additional cost).

November 7, 2024 by matray

Positive Physicians Insurance Co. promoted Cobie Buchman to the senior vice president and chief claims officer. This promotion reflects Buchman’s significant contributions to the company and his commitment to enhancing Positive Physicians’ claims capabilities.

Buchman joined Positive Physicians in 2023 as senior vice president of claims and has been instrumental in elevating the performance and efficiency of the company’s claims team. With more than 24 years of national claims experience in medical professional liability, Buchman has played a key role in expanding Positive’s growth initiatives, transforming the company's reinsurance program, and refining and adding rigor to all aspects of the claims process, including claims committee, reserving, analysis and disposition of complex claims.

“Since joining Positive, Cobie has demonstrated exceptional leadership and a deep understanding of the medical professional liability industry,” said Michael G. Roque, Positive Physicians Insurance Co. chief executive officer. “His expertise has been critical in enhancing our claims operations and supporting our strategic objectives. We are confident that in his role as SVP & Chief Claims Officer, Cobie will continue to drive innovation and excellence within our claims department.”  

October 10, 2024 by matray

LAMMICO congratulates Lafayette Surgical Specialty Hospital in Lafayette, La., the recipient of the 9^th Annual LAMMICO Patient Safety Award and Grant. The 2023-2024 Patient Safety Award and Grant centered on falls prevention. Preventing patient falls is a top priority for patient safety, patient satisfaction, quality reputation and cost reduction. Patient falls may result in injuries such as lacerations, fractures, intracranial bleeding and death. Compared to patients who do not suffer falls, those with fall-induced injuries stay in the hospital longer and incur higher hospital costs. To decrease patient falls in the hospital or ambulatory surgery setting, a multifaceted approach with standardized and customized interventions is needed. Developing an evidence-based falls prevention program is essential. This grant program encouraged participating hospitals to tackle this challenge and reduce their patient fall rates.

Grant applicants completed falls prevention online courses in LAMMICO’s learning management system. These courses focused on information about falls, recommended interventions for falls prevention programs, and how staff can help prevent patient falls.

By demonstrating the best improvements (in policies, procedures, protocols and/or processes) related to a reduction in patient fall rates after completing this risk management and patient safety education, Lafayette Surgical Specialty Hospital (LSSH) was awarded:

• $10,000 grant for nursing professional development
• One-year Risk Manager membership to the American Society for Healthcare Risk Management (ASHRM)

One of the steps taken by the team at LSSH to prevent falls included staff helping all patients with dressing. A “Call Before You Fall” program was implemented throughout the hospital. It included educational patient signage. The staff placed all patients in a chair or on the side of the bed with the side rails up, rather than on the side of the bed, while a wheelchair was obtained for discharge. LSSH had a 40% decrease in patient falls for the three-month post-education period, as compared to the three-month pre-education period.

Specialists Hospital Shreveport in Shreveport, La., is the second place participant of the Patient Safety Award and Grant. A grant of $5,000 for nursing professional development and a one-year Risk Manager membership to ASHRM was presented to this hospital in recognition of this honor.

After participating in the grant program, Specialists Hospital Shreveport learned that one of the best falls prevention steps is to better educate staff. They updated their falls prevention policy and procedures. They also developed an educational presentation that is used during new staff orientation to teach falls prevention strategies.

LAMMICO commends these two hospitals and all others who submitted award applications, for their commitment to improving patient safety.