A.M. Best Affirms Credit Ratings of Members of MedPro Group

July 11, 2019 by matray

A.M. Best has affirmed the Financial Strength Rating of A++ (Superior) and the Long-TermIssuer Credit Ratings of “aa+” of the members of MedPro Group (MedPro) (headquartered in Fort Wayne, IN). These Credit Ratings (ratings) apply to The Medical Protective Company (Fort Wayne, IN), its affiliates: Princeton Insurance Company (Princeton, NJ); PLICO, Inc. (Oklahoma City, OK); Wellfleet Insurance Company (Fort Wayne, IN); and Wellfleet New York Insurance Company (Flushing, NY); as well as MedPro’s two reinsured affiliates, MedPro RRG Risk Retention Group and AttPro RRG Reciprocal Risk Retention Group (both domiciled in the District of Columbia). The outlook of these ratings is stable.

The ratings reflect MedPro’s balance sheet strength, which A.M. Best categorizes as strongest, as well as its strong operating performance, favorable business profile and appropriate enterprise risk management.

The ratings also acknowledge MedPro’s robust capitalization, long-term operating performance and the significant market position it maintains in the medical professional liability (MPL) sector. Additionally, the ratings consider the group’s substantial distribution capabilities, prudent claims-handling philosophy and culture of maintaining a margin of safety. Furthermore, the ratings benefit from the explicit and implicit financial support provided by the ultimate parent, Berkshire Hathaway Inc., which includes reinsurance programs, investment opportunities and capital support.

Partially offsetting these positive rating factors are the inherent challenges associated with being a predominately monoline MPL insurer, particularly as they relate to price competition, changing market dynamics, potential changes in legislation (i.e., tort reform), increasing loss cost trends and regulatory risk. At the same time, AM Best recognizes the organization’s strong management team, broad premium base and jurisdictional diversity that mitigate these concerns.

Downward rating pressure may result from a significant decrease in risk-adjusted capitalization from an adverse earnings trend due to underwriting or investment losses. Downward rating pressure also may result should the group’s relationship with Berkshire Hathaway Inc. or National Indemnity Company change, which also would result in a diminution of the business profile.

July 1, 2019 by matray

AMA Abortion Lawsuit Puts Doctors In The Thick Of Debate

Julie Rovner, Kaiser Health News The American Medical Association is suing North Dakota to block two abortion-related laws, the latest signal the doctors’ group is shifting to a more aggressive stance as the Trump administration and state conservatives ratchet up efforts to eliminate legal abortion.

The group, which represents all types of physicians, has tended to stay on the sidelines of many controversial political issues, and until recently has done so concerning abortion and contraception. Instead, it has focused on legislation that affects the practice and finances of large swaths of its membership.

But, said AMA President Patrice Harris in an interview, the organization felt it had to take a stand because new laws forced the small number of doctors who perform abortions to lie to patients, putting “physicians in a place where we are required by law to commit an ethical violation.”

One of the laws, set to take effect Aug. 1, requires physicians to tell patients that medication abortions — a procedure involving two drugs taken at different times — can be reversed. The AMA said that is “a patently false and unproven claim unsupported by scientific evidence.” North Dakota is one of several states to pass such a measure.

The AMA, along with the last remaining abortion clinic in the state, is also challenging an existing North Dakota law that requires doctors to tell pregnant women that an abortion terminates “the life of a whole, separate, unique, living human being.” The AMA said that law “unconstitutionally forces physicians to act as the mouthpiece of the state.”

It’s the second time this year the AMA has taken legal action on an abortion-related issue. In March, the group filed a lawsuit in Oregon in response to the Trump administration’s new rules for the federal family planning program. Those rules would, among other things, ban doctors and other health professionals from referring pregnant patients for abortions.

“The Administration is putting physicians in an untenable situation, prohibiting us from having open, frank conversations with our patients about all their health care options — a violation of patients’ rights under the [AMA] Code of Medical Ethics,” wrote then-AMA President Barbara McAneny.

It’s an unusually assertive stance for a group that has taken multiple positions on abortion-related issues over the years.

Mary Ziegler, a law professor at Florida State University who has written several books about abortion, said that the AMA’s history on abortion is complicated. In general, she said, the AMA “didn’t want to get into the [abortion] issue because of the political fallout and because historically there have been doctors in the AMA on both sides of the issue.”

In recent years, the AMA has taken mostly a back seat on abortion issues, even ones that directly addressed physician autonomy, leaving the policy lead to specialty groups like the American College of Obstetricians and Gynecologists, which has consistently defended doctors’ rights to practice medicine as they see fit when it comes to abortion issues.

Ziegler said it is not entirely clear why the AMA has suddenly become more outspoken on women’s reproductive issues. One reason could be that the organization’s membership is skewing younger and less conservative. Also, this year, for the first time, the AMA’s top elected officials are all women.

In its earliest days, the AMA led the fight to outlaw abortion in the late 1800s, as doctors wanted to assert their professionalism and clear the field of “untrained” practitioners like midwives.

Abortion was not an issue for the group in the first half of the 20th century. The AMA became best known for successful fights to fend off a national health insurance system.

Leading up to Roe v. Wade, the 1973 Supreme Court decision that legalized abortion nationwide, the AMA softened its opposition. In 1970, the AMA board called for abortion decisions to be between “a woman and her doctor.” But the organization declined to submit a friend-of-the-court brief to the high court during its consideration of Roe.

In 1997, the AMA, in a surprise move, endorsed a GOP-backed measure to ban what opponents called “partial-birth abortions,” a little-used procedure that anti-abortion forces likened to infanticide. A year later, however, an audit of the AMA’s leadership found its trustees had “blundered” in endorsing the bill and had contradicted long-standing AMA policy.

One reason the organization may be moving on the issue now could be the shifting parameters of the abortion debate itself. In 1997, the abortion procedure ban that the AMA endorsed “polled well and allowed abortion opponents to paint the other side as extremist,” Ziegler said.

Exactly the opposite is true today, she said, as states pass abortion bans more sweeping than those seen at any time since Roe v. Wade. Yet most public opinion polls show a majority of Americans want abortion to remain legal in many or most cases.

“As abortion opponents take more extreme positions, the AMA is probably a little more comfortable intervening” Ziegler added.

Molly Duane, a lawyer from the Center for Reproductive Rights who is arguing the case for the AMA and North Dakota’s sole remaining abortion clinic, said the laws being challenged are “something all doctors should be alarmed by. … This is an unprecedented act of invading the physician-patient relationship and forcing words into the mouths of physicians.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

Brian J. Spero Is Appointed to Coverys’ Board of Directors

June 21, 2019 by matray

Coverys announced the appointment of Brian J. Spero to the Medical Professional Mutual Insurance Company board of directors.

Spero has more than 30 years of proven expertise as a senior executive in insurance operations, legal, regulatory and administrative leadership roles. Spero currently serves as the president and CEO of The Beacon Mutual Insurance Company. In this role, he leads the organization’s strategic corporate vision, ensuring Beacon’s fiscal strength, including investment strategy, preservation of assets, reinsurance programs and claim reserve requirements. Spero previously served as executive vice president, chief operating officer and general counsel of Beacon.

“Brian is a great addition to the board and brings a wealth of experience developing and maintaining strategic alliances to coordinate the delivery of comprehensive, high-quality, and cost-effective insurance programs,” said Brenda E. Richardson, MD, chair of the board of directors. “The board and management look forward to working with him in the coming years.”

Prior to joining The Beacon Mutual Insurance Company, Spero was a founding partner of Partridge Snow & Hahn LLP, a partner and associate at Tillinghast, Collins & Graham in Providence, R.I., and law clerk to the Honorable Francis J. Boyle, United States District Court, District of Rhode Island.

Spero serves on the Rhode Island Governor’s Insurance Council, the Greater Providence Chamber of Commerce Board of Directors, the Rhode Island Public Expenditures Council, and the Meeting Street School Audit and Finance Committee. He also serves as a Bank of Newport corporator, an American Association of State Compensation Insurance Funds vice president & executive committee member, and is a member of the Association of Corporate Counsel, the Rhode Island Bar Association, and the Massachusetts Bar Association. He is admitted to practice of law in Rhode Island and Massachusetts. Spero obtained a Juris Doctor from Boston College Law School and a Bachelor of Arts from Colgate University.

NY DFS Approves Acquisition of Hospital Insurance Company by The Doctors Company

June 20, 2019 by matray

Acting New York Financial Services Superintendent Linda A. Lacewell today announced that the Department of Financial Services (DFS) has approved the application of The Doctors Company (TDC) to purchase Hospitals Insurance Company (HIC) from Maimonides Health Resources, Inc., Montefiore Medicine Academic Health System, Inc. and Mount Sinai Health System, Inc., for $638 million. TDC will also purchase the assets and liabilities of HIC’s current manager, FOJP Service Corp., from the sellers for $12 million.

“Taking into consideration the importance and current status of New York’s medical malpractice market, DFS carefully reviewed this acquisition to protect HIC policyholders,” said Acting Superintendent Lacewell. “The measured expansion of competition in the medical malpractice market by a DFS-regulated insurer is positive for doctors, and ultimately good for consumers.”

“We are pleased the New York Department of Financial Services has given final approval for this important transaction. This enables us to deliver on our commitment to New York physicians and hospitals to provide expanded coverage options from a strong admitted carrier, and to build a mission-based platform to serve the medical professions. We look forward to the transaction closing on July 31, 2019,” said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company.

Center For Justice & Democracy Releases New Briefing Book — Medical Malpractice: By The Numbers

June 20, 2019 by matray

The Center for Justice & Democracy at New York Law School (CJ&D) today released the 12th update to its MedicalMalpractice: By The Numbers briefing book. The fully-sourced, 172-page volume includes the latest statistics and research on issues related to medical malpractice, including more than 500 footnotes linking to original sources. The briefing book’s release coincides with renewed attention to the topic of medical negligence, namely this Sunday’s premiere of “License to Kill,” a new Oxygen television series that focuses on medical malpractice.

“Viewers of the new series, and indeed anyone interested in learning more about the extent of avoidable patient injuries in this country, should turn to the briefing book as a resource,” said principal briefing book author, CJ&D’s Deputy Director for Law & Policy, Emily Gottlieb.

As in prior editions, topics include: medical malpractice litigation, healthcare costs and “defensive medicine,” physician supply and access to healthcare, medical malpractice insurance, patient safety and special problems for vets and military families. In addition, there are several new sections, including sexual assault by doctors, misdiagnoses (the most prevalent and costly type of medical error), childbirth negligence, plastic surgery, how physician stress and burnout leading to errors and the real cause of insurance spikes for doctors. Among the many new research findings since CJ&D’s December 2019 update are:

• Between 2007-2016, the number (frequency) of medical malpractice cases dropped more than 25%. For ob/gyns, the drop was 44%.

• Ninety-percent of doctors with at least five medical malpractice claims are still in practice.

• There is no “quality of care” information available for 75% of doctors treating Medicare patients.

• The federal government doesn’t require hospitals to tell the public how often mothers die or suffer from childbirth complications.

• After Texas enacted severe “tort reform” measures in 2003, access to medical care grew by “close to zero.”

• When a state caps damages, rates for cardiac stress tests and other imaging tests, Medicare Part B lab and radiology spending, all rise.

• When it comes to preventing deaths from medical errors, out of 195 countries in the world, the U.S. ranks below the top 50.

“Organized medicine continues to push laws that would reduce the accountability of unsafe hospitals and incompetent physicians,” said CJ&D Executive Director Joanne Doroshow, who edited the briefing book.

“Yet hundreds of thousands of patients die each year due to preventable medical errors at the same time insurance claims and lawsuits are dropping.

“We have an enormous patient safety problem in this nation. Even sexual misconduct by physicians is going largely unchecked. The last thing we should do is try to solve these problems by increasing the obstacles harmed patients face in the already difficult process of bringing a case against the person or institution that harmed them.”

A copy of the full briefing book can be found here: http://centerjd.org/content/briefing-book-medical-malpractice-numbers

Denise M. Condron promoted to Vice President of Loss Prevention and Kevin M. Bresnahan, JD, promoted to Vice President of Claims at CMIC Group

June 19, 2019 by matray

CMIC Group announced that Denise M. Condron, previously the Director of Loss Prevention, has been promoted to the role of Vice President of Loss Prevention. Additionally, Kevin M. Bresnahan, JD, the prior Director of Claims, has been promoted to the role of Vice President of Claims.

Condron has more than 20 years of healthcare experience in both clinical and administrative roles. In 2017, under her leadership, the company’s CME Program received Accreditation with Commendation from the Connecticut State Medical Society, and more recently, she led the CMIC’s return to the MPL Association Data Sharing Project. She has worked to expand the CMIC Loss Prevention Education Program to include additional enduring materials, live events and most recently, the inclusion of webinars.

“Denise has been instrumental in providing high-quality programs and support services to our physicians and their practices,” said Stephen J. Gallant, Chief Executive Officer of CMIC Group. “Her ongoing efforts and expertise have become a valuable resource to our members.”

Bresnahan has more than 25 years of experience as both a defense trial attorney and an insurance claims executive. In addition to leading the Claims Department, he has played a major role in defending policyholders while protecting the overall interest of the company. His responsibilities have recently expanded to include lobbying and governmental affairs.

“Kevin’s extensive litigation and claims management experience have proven to be an asset for policyholders as they navigate the claim process,” Gallant said. “His contributions continue to produce positive changes beyond the Claims Department.”

MIEC to Host ‘Summit for Insurance Defense’ on June 20

June 12, 2019 by matray

MIEC announced its inaugural MIEC Summit for Insurance Defense will take place in Boise, Idaho, on June 20, 2019. The Summit for Insurance Defense is a new annual regional seminar series. Each year it will be hosted in one of MIEC’s territories. The goal of this seminar series is to bring together physicians, practice managers and legal professionals to learn and network.

The event will take place at Boise’s Riverside Hotel where attendees can pick one of two educational seminar tracks focusing on either Idaho Law or Patient Safety & Risk Management. Each track features two, one-hour sessions with communal breaks in between. Attendees will learn proactive methods of protecting a practice from potential liabilities and how best to defend clients, with the opportunity to earn CLE credits for those eligible.

The legal track speaker panel features staples of the Boise legal community: Raymond Powers, Esq., of Powers Farley PC; Keely Duke, Esq., of Duke Scanlan & Hall, and Andrew Brassey, Esq., of Brassey Crawford & Howell, PLLC.

During the second legal session, attendees will learn effective strategies to address jury selection in cases involving hospital and independent providers, effective voir dire strategies and latest jury selection trends. Furthermore, attendees will gain insight into being able to successfully navigate the challenges of presenting evidence in an abbreviated trial schedule, prepare and present witnesses in theses challenged schedules, and develop tactics to keep jurors engaged through disruptive trial schedules.

The patient safety risk management track features nationally recognized practice management specialists Debra Phairas, president of Practice & Liability Consultants, LLC, and Kim Stanger of Holland & Hart, LLP. Their sessions will center around minimizing practice liability. Focusing on aging, impaired or otherwise disruptive physicians in a practice, as well as addressing ways to minimize risk when employing non-physicians in your practice.

Following the educational seminars, both tracks will come together for a joint keynote presentation from Justin Skeesuck and Patrick Gray. Justin and Patrick have had a unique friendship that spans over 42 years. Despite the many challenges of a progressive neuromuscular disease robbing Justin of the use of his arms and legs, the two seek to live life without reservation. Justin and Patrick use their life/work experiences and their adventures as the backdrop to which they explore concepts such as leadership, teamwork, relationship and the power of the human collective.

Finally, the seminar will close out with a social cocktail hour, allowing attendees to meet, socialize and network among fellow medical and liability professionals.

To learn more and to register for FREE, please visit the Summit for Insurance Defense page by clicking HERE.

Webinar: The Growing Cost of Defending Medical Malpractice Claims and How to Reverse the Trend for Doctors, Hospitals and Insurance Companies

June 12, 2019 by matray

During the past fifteen years, the number of malpractice claims filed has dropped significantly (as much as 27% according to the CRICO 2018 CBS Benchmarking Report). That's good news for insurance companies, doctors and hospitals.

But while the frequency of claims went down, the cost of defending a malpractice lawsuit rose materially (3.5% for all claims and 5% for those without indemnity, according to the CRICO 2018 CBS Benchmarking Report) during that same period, with annual trend rates ranging in the mid to upper single digits for some segments.

The reduction in the frequency of claims has masked the problem of increased defense costs. And this increase is having an industrywide impact. Before claims costs get any higher, now is the perfect time to take a serious look at what your organization is doing to handle these claims and, based on your findings, how to reduce these rising costs.

So what's behind the increased costs of defending a claim? What processes are likely to have the biggest impact on them? Do you have confidence that the data you're collecting will support your claims strategies going forward? And are you open to some nontraditional strategies that could help you better control costs?

Get answers to these questions and more when you register to attend "The Growing Cost of Defending Medical Malpractice Claims and How to Reverse the Trend for Doctors, Hospitals, and Insurance Companies" on Thursday, June 27, 2019. We've put together a panel of experts who will provide you with a medical malpractice insurance industry status report and a picture of where things are headed. You'll learn how and why costs are increasing and what you can do to reduce them.

Click Here to Register

Experts Make Sense of It All
Listen as Mark Reynolds of CRICO reviews the results of its most recent study Medical Malpractice in America: A 10-Year Assessment with Insights. Find out some of the reasons that claims-and even the time to process those claims-are down. You'll learn why the number of cases with multiple defendants has increased by about 20% and how that can affect your costs. And why the largest increase in those costs is from cases with no indemnity payment at all.

Next, you'll hear from Chad Karls. His company, Milliman Inc., has collected significant data on the cost of defending a claim. He'll share some of what Milliman has learned from this data and provide you with insights and examples of how, in some cases, nontraditional thinking is challenging the way claims are managed to better control costs.

And finally, Tim Smith from the NORCAL Group will show you how to analyze data and put it to practical use within your organization to enhance the value proposition for your customers. You'll learn what NORCAL did to uncover outdated strategies and how they were able to eliminate waste and drive efficiency in a coordinated and collaborative manner.

You'll come away with insights that will help you develop actionable strategies that you start working on as soon as you log off your computer at the end of the webinar.

Who Should Attend?
Whether you're a medical liability insurance professional, hospital or healthcare executive, or risk manager-anyone who needs to get a better handle on the rising cost of defending malpractice claims and ways to reverse this trend — this is one webinar you can't afford to miss.

Register today to guarantee your place at this essential learning session. And remember that your entire team in one location can participate with you when you register.

Medical Liability Monitor Webinar at a Glance
DATE: Thursday, June 27, 2019 TIME: 2 p.m. EDT; 1 p.m. CDT; 12 p.m. MDT; 11 a.m. PDT
PLACE: Your computer
COST: $147 per site (unlimited attendance at one location) through 6/14/19, $197 thereafter
TO REGISTER: Click here or email leslie@medicalliabilitymonitor.com

Here is just some of what you'll learn during this in-depth 90-minute conference:
• Why the cost of defending medical malpractice claims is going up — and what you can do to reverse the trend.

• How to determine which of your defense firms is best for specific types of claims.

• How to find and fix some of the problem areas within your organization.

• Where to find data you can use to streamline processes, create strategies, and cut costs.

• How to turn your data into usable, actionable information to effectively manage legal costs.

• How to switch from "the way it's always been done" to thinking outside the box, and the potential benefits of trying something new.

• The data you need and how to use it to support your claims strategies going forward.

• The increased use of "disclosure and apology" and whether or not it reduces the likelihood of a lawsuit... and much more!

Distinguished Presenters
Chad C. Karls, FCAS, MAAA, has been a principal and consulting actuary with Milliman since 1993. His areas of expertise include property and casualty insurance, particularly ratemaking, loss reserve analysis, and financial planning. Mr. Karls also has an understanding of defense costs and has developed an advanced analytics platform that extracts the intelligence from attorney invoices.

Mr. Karls has published 50 articles on medical professional liability issues in Best’s Review, Medical Liability Monitor, National Underwriter, Bureau of National Affairs – Health Care Policy Report, and Inside Medical Liability and has been quoted in The Wall Street Journal, Best Week, U.S. Insurer, American Medical News, and Medscape Medical News. In addition, Mr. Karls has spoken more than 100 times at various industry conferences, including those sponsored by the Casualty Actuarial Society, the Medical Professional Liability Association, A.M. Best Company, and others.

Mr. Karls has a B.S. in actuarial science from the University of Wisconsin and is a Fellow of the Casualty Actuarial Society and a member of the American Academy of Actuaries.

Mark E. Reynolds is President and CEO of the Risk Management Foundation of the Harvard Medical Institutions Incorporated (CRICO). CRICO insures 25 hospitals, nearly 13,000 physicians, and more than 200 other health care organizations for professional liability. The CRICO program also insures 100,000+ employees, including nurses, physician assistants, and clinical support staff. In addition, CRICO is a leader in patient safety, simulation and team training, and risk management.

Mr. Reynolds has 20 years of experience in the healthcare and insurance industries, most recently as CEO of Neighborhood Health Plan of RI, where his outcome-driven approach resulted in it being rated among the nation’s top 10 Medicaid health plans.

Timothy Smith is the Chief Claims Officer of the NORCAL Group. With more than 30 years of experience in the legal and insurance industries, he has held claims leadership positions at various national and local companies.

Prior to working in the insurance industry, Mr. Smith practiced law in California and Illinois, specializing in medical malpractice, products, and general liability.

Mr. Smith received his Bachelor of Science in commerce/accounting from DePaul University in Chicago and his Juris Doctor from the McGeorge School of Law in California.

Click Here to Register  

Physicians’ Reciprocal Insurers to Present Webinar “How to Respond to Document Requests, Audits and Overpayment Demands”

June 10, 2019 by matray

Physicians' Reciprocal Insurers (PRI) announced an upcoming, June 25, webinar on "How to Respond to Document Requests, Audits and Overpayment Demands."

Presented in partnership with Frier Levitt, a national healthcare law firm, this webinar will provide valuable information for both physicians and practices on how to mitigate the risk of, and respond to audit notices, document requests, and overpayment demands. Knowing what to expect and understanding the best course of action can help protect your professional license, save money, and avoid litigation.

The webinar will be hosted by Guillermo J. Beades, Esq., senior counsel for Frier Levitt's Healthcare Litigation Department. Beades has extensive litigation experience within the healthcare field including litigating before state licensing authorities, federal healthcare agencies and state healthcare agencies.

According to PRI, this webinar will take you through the process of what to do when receiving a request or demand from a government agency or private payor, which will include:

• How to identify if a document request is problematic

• Current audit trends with a focus on the codes, modifiers, and procedures that are a substantial risk for triggering an audit

• How to formulate an action plan to respond to audits and document demands

• How physicians and practices can protect themselves and low lower the risk of adverse audit findings

• Identifying common pitfalls and how to avoid them

This free webinar will take place on Tuesday, June 25, from 2-3 p.m. To register for this event please use this Registration Link.

For additional information, please contact Katherine Guglielmo at KGuglielmo@frierlevitt.com.

A.M. Best Places Credit Ratings of CMIC Group’s Members Under Review With Negative Implications

June 7, 2019 by matray

A.M. Best has placed under review with negative implications the Financial Strength Rating of A- (Excellent) and the Long-Term Issuer Credit Ratings of “a-” of Connecticut Medical Insurance Company (Glastonbury, CT) and its sponsored risk retention group company, CMIC Risk Retention Group (District of Columbia). These companies are referred to collectively as CMIC Group (the group).

The under review status considers several strategic initiatives that management plans to execute during the third quarter of 2019 and the benefits these are expected to have on the group’s prospective operating results. These initiatives, combined with corrective underwriting actions introduced by management in the prior year, are expected to improve the group’s operating performance, which has suffered in recent years due to increased claims severity, diminishing reserve redundancies, and a declining premium base. A.M. Best views these initiatives being taken in the upcoming quarter as material and therefore, failure to execute on these plans is likely to result in negative ratings pressure, hence the negative rating implications. The ratings will remain under review pending further discussions with management and, more importantly, the execution of these new initiatives.