January 25, 2011 by matray

side note: I find this very interesting. In today's partisan political climate, can Sens. Daschle and Frist find common ground to the nation's healthcare ailments? Calling “constructive engagement on health reform vital to our nation’s future,” the Bipartisan Policy Center (BPC) launched its Health Project on Jan. 18, led by former Senate Majority Leaders Tom Daschle and Bill Frist as well as former Gov. Ted Strickland. “We know there remains a great political divide over the future of the healthcare system, but the need for substantive discussions and cooperation has never been greater,” said Sen. Daschle. “An economically sustainable health system is in our collective interest, and I look forward to working with the states to help them lead the way with health reform. If the states succeed, we as a nation will make significant progress.” The BPC will embark on a comprehensive review of the numerous challenges and opportunities confronting states as they deal with delivery, cost and coverage demands in their health systems. Through a series of private and public discussions, the BPC will engage state, federal, business and workforce leaders over the next year. “The emphasis on a strong, active state role is the most significant element of the new healthcare law, and moving forward we need to continue to create and implement solutions that work for state leaders,” said Sen. Frist, referring to the Patient Protection & Affordable Care Act. “While the law is not perfect, it is now the foundation upon which all future reform will be based. Working in close coordination with the states, our project will provide support as they make crucial and often difficult healthcare decisions. We must face our healthcare crisis, and I look forward to making real progress on these issues through this substantive and forward-leaning project.” The BPC Health Project is initially focusing on several key areas of concern: insurance exchanges; insurance reforms; and delivery system reforms, including health information technology, the health professional workforce, healthcare efficiency and medical malpractice reform. For each issue area, the BPC will identify and share best practices among the states and host roundtable discussions to facilitate a thoughtful, bipartisan dialogue among stakeholders at the state and federal level and in the industry and marketplace. “We will be collaborating together to target and highlight a range of solutions, not just one solution, to the many financing and delivery challenges facing the states,” said Gov. Strickland. “To ensure that we are responsive to and truly understand different state needs, our project will seek input and guidance from a broad group of both Republican and Democratic governors. The debate about healthcare reform is ongoing, but it is my hope that our effort will go beyond the rhetoric and deliver pragmatic, practical approaches that work.” Sens. Daschle and Frist as well as Gov. Strickland will lead the project with guidance from healthcare experts and project co-directors Sheila Burke and Chris Jennings. The BPC’s first healthcare project culminated in the release of a bipartisan blueprint for healthcare reform, Crossing Our Lines, by former Senate Majority Leaders Howard Baker, Tom Daschle and Bob Dole in June 2009. The Bipartisan Policy Center (BPC) is a non-profit organization that was established in 2007 by former Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole and George Mitchell to develop and promote solutions that can attract public support and political momentum in order to achieve real progress.

January 25, 2011 by matray

side note: While Ohio's closed medical professional liability claims experience an uptick in 2009, the total is still down 33 percent from the 5,051 claims that closed cataloged in the report's inaugural edition from 2005. The Ohio Department of Insurance recently issued its fifth annual Ohio Medical Professional Liability Closed Claim Report. Data collected from entities providing medical professional liability coverage to Ohio healthcare providers and healthcare facilities shows a total of 3,344 medical professional liability claims were closed in 2009. Claims that generated an indemnity payment averaged $322,158 per closed claim. Ohio law requires all entities that provide medical professional liability insurance in Ohio—including authorized insurers, surplus lines insurers, risk retention groups and self-insurers—to annually report closed claim data to the Department of Insurance. Claims are reported to the department and included in analysis based on the year in which they reach final outcome. The specific data filed by each reporting entity is confidential and is not subject to public record requests. The department is required to prepare an annual report summarizing the closed claims on a statewide basis. Some key findings in the report include:   • Total Closed Claims: A total of 3,344 closed claims were reported for 2009 by 99 entities. Authorized insurers reported the majority of the closed claims, 1,796. Self-insured entities reported 1,185 closed claims, surplus lines insurers reported 212 closed claims and risk retention groups reported 151 closed claims. For 2008, a total of 3,080 closed claims were reported.   • Indemnity Payments: Seventy-six percent of medical malpractice closed claims resulted in no payment to a claimant. A total of 2,542 closed claims had no indemnity payments while 802, or 24 percent, closed with an indemnity payment. The total amount paid to claimants was $258,370,436, an average of $322,158 per closed claim for those claims that generated an indemnity payment. Based on the combined data of all five years, approximately 22 percent of the closed claims generated an indemnity payment at an average of $287,931.  • Closed Claim Expenses: While most medical malpractice claims closed with no payments to claimants, almost all closed claims generated expenses for investigation and defense. These expenses totaled $107,739,769, an averageof $39,350 per closed claim. Based on the combined data for all five years, the average expenses per closed claim were $32,071.

January 24, 2011 by matray

side note: Here is an interesting wrinkle in the Kansas Supreme Court's hearing on the constitutionality of the state's cap on non-economic damages. It is quite unusual for a court to order a re-argument of a case before it. TOPEKA — In a rare move, a highly watched medical malpractice lawsuit will be re-argued before the Kansas Supreme Court. Chief Justice Lawton Nuss on Friday ordered re-arguments for 9 a.m. Feb. 18 in the case where a doctor removed the wrong ovary from a Eudora woman. The dispute is over a cap in damages to the woman and has pitted some of the state’s largest special interests against each other. The Supreme Court first heard arguments in the case in October 2009, and has not issued a decision. Since then, former Chief Justice Robert Davis died and has been replaced by Justice Nancy Moritz. It was also announced Friday that Justice Eric Rosen would recuse himself from the case, although no reason was given. He will be replaced by David Knudson, a retired judge from the Kansas Court of Appeals. Each side will be given 90 minutes before the court. Nuss has ordered that no further legal briefs will be allowed to be submitted. Already numerous interests have weighed in on the case. In 2002, Amy Miller went in for surgery to remove her right ovary. Dr. Carolyn Johnson removed her left ovary by mistake. Johnson continues to practice in Lawrence, working on the staff of the Kansas University Watkins Memorial Health Center. Miller sued for malpractice. In 2006, a Douglas County jury returned a verdict for Miller for $759,680. The award included $250,000 for noneconomic losses; $150,000 for future noneconomic losses; $84,680 for medical expenses; $100,000 for future medical expenses; and $175,000 for loss or impairment of services as a spouse. Noneconomic losses are awarded for pain, suffering, disability, mental anguish and physical disfigurement. But then-District Court Judge Steve Six reduced the award downward by striking the $150,000 for future noneconomic losses because of a law that states that noneconomic damages can’t go above $250,000. He also struck down the $100,000 for future medical expenses. Miller’s attorneys, supported by unions, claim the $250,000 cap violates a person’s constitutional right to trial by jury and infringes on the constitutional authority of the judiciary. remainder of article

January 19, 2011 by matray

side note: Here is some interesting tort refrom legislation winding its way through the New Jersey state assembly. With newly elected Gov. Chris Christie at the helm, I wouldn't be surprised to see this bill get renewed attention. A longstanding bill slowly making its way through the New Jersey legislature urges reform of tort laws that some say are forcing qualified physicians to leave the state. The legislation, Assembly Bill A-1982, aims to limit the ability of medical malpractice insurers to raise premiums on doctors unless they are actually found guilty of medical malpractice. Current law allows a physician's medical malpractice insurer to increase the cost of insurance coverage at the simple filing of a malpractice action; no finding of wrongdoing is actually required. This has many in the medical community—including representatives of the Medical Society of New Jersey, the New Jersey Chapter of the American College of Surgeons and the Monmouth-Ocean Medical Society—viewing the promise of increased insurance premiums as having a chilling effect upon the medical community throughout the state. Proponents of the law argue that giving physicians the opportunity to defend themselves against frivolous claims without suffering unwarranted consequences will raise the bar for health treatment for people across New Jersey by stopping the migration of some of New Jersey’s most highly qualified doctors to neighboring states with more doctor-friendly insurance practices. Supporters also point to the ever-increasing expenses associated with “defensive medicine” as inflating the cost of medical care for everyone, and they argue that the reforms proffered by A-1982 will help make treatment more affordable across the board.

January 17, 2011 by matray

side note: If you're looking for a silver lining to the economic downturn, a new report from Towers Watson indicates the economy has had a shrinking effect on our nation's tort costs. A decline in both real and nominal GDP, a rising unemployment rate and decreasing tort activity as a result of a lower level of economic activity helped drive tort costs down by 2.7 percent, or $6.8 billion, in the United States in 2009, according to the 2010 Update on U.S. Tort Cost Trends from global professional services company Towers Watson. In total, The U.S. tort system cost $248.1 billion in 2009, which translates to $808 per person, versus $838 per person in 2008. The 2010 report analyzes U.S. tort costs from 1950 through 2009, with projections through 2012. The drop-off in 2009 was most evident in commercial tort costs, as total tort costs from commercial lines decreased 5 percent from 2008 to 2009. At $152.7 billion, 2009 commercial tort costs were 11.9-percent lower than average commercial tort costs in the peak years 2004 and 2005. The decline in commercial tort costs offset modest gains in personal tort costs—torts alleged against individuals, excluding medical malpractice—which increased slightly from $94.2 billion in 2008 to $95.4 billion in 2009. “The lack of a robust economy contributed to a decrease in the opportunity for tort actions,” said Russ Sutter, Towers Watson consultant and author of the report. “This decline was most notable in the commercial auto line of business—perhaps the most economically sensitive coverage with a tort component—as insured commercial auto tort costs fell by 7.4 percent in 2009. “We had also anticipated a surge of directors and officers liability litigation in 2009, largely related to the credit crisis that began in 2008,” Sutter said. “However, the costs of this litigation are lower than we were expecting.” Further, overall economic growth in 2009 was minus-1.3 percent. As such, the ratio of tort costs to gross domestic product shrank in 2009, marking six consecutive years of a decline in the ratio. Since 1950, growth in tort costs has exceeded growth in GDP by an average of about two percentage points. Looking ahead to 2010, Towers Watson is forecasting a 9-percent increase in tort cost, primarily due to the BP Deepwater Horizon disaster in the Gulf of Mexico. Excluding the Gulf spill, however, Towers Watson estimates tort costs in 2010 to be fairly stable. “Automobile-related tort costs remain subdued due to the weak economy, and medical malpractice trends continue to be mild,” Sutter said. “We do, however, expect an uptick in the employee practices liability arena, with increasing disputes related to overtime compensation.” Towers Watson estimates growth in U.S. tort costs to range from 1 to 5 percent in 2011, with a midpoint of 3 percent, excluding the impact of the BP oil spill. A higher increase is seen for 2012, with a midpoint of 4 percent.

January 13, 2011 by matray

The American Tort Reform Foundation (ATRF) recently released its 2010/2011 Judicial Hellholes report, which annually names what it considers some of the nation’s “most unfair civil court jurisdictions.” The ATRF is a branch of the American Tort Reform Association (ATRA), an umbrella organization exclusively dedicated to reforming the civil justice system with a nationwide network of state-based liability reform coalitions. Since its inception in 2002, the Judicial Hellholes program has documented in published reports various abuses within the civil justice system, focusing primarily on jurisdictions where “courts have been radically out of balance.” This year marks the first time that the report has been released online via its new companion website, located at www.judicialhellholes.org. ATRF said that the new website will serve as its principal platform in the future and allow the organization to update problem jurisdictions in real time. “As both technology and the liability-expanding strategies of the always formidable litigation industry evolve, we believe our Judicial Hellholes program must evolve, too,” said Victor Schwartz, ATRA general counsel. “So, as we begin providing year-round updates and analyses of civil justice developments online, our reporting will remain largely focused on the judicial branch, but we’ll occasionally include legislative and executive branch actions that affect the civil justice system, too.” As expected at the yearly publishing of the ATRF’s report, representatives of the plaintiff’s bar and consumer-advocacy organizations have cried foul, citing the sources of the organization’s funding as well as its new intimidation tactics. “ATRA has been funded by corporate giants such as Philip Morris, Dow Chemical, Exxon, General Electric, Aetna, Geico, State Farm, Pfizer, Johnson & Johnson and Nationwide—a ‘who’s who’ of corporations with the most to gain by shutting the courthouse doors on consumers,” wrote the American Association for Justice, the nation’s largest trial bar, in a press release discharged the same day as the Judicial Hellholes report. “Legal Times has also reported that, ‘most of ATRA’s funding comes from large corporate donors. Insurance firms … are each good for $50,000 or $75,000, one unnamed lobbyist familiar with the Association told the publication.’ “The group is now apparently also going ‘online’ with continuous updates, hoping that judges will now have to continuously look over their shoulder wondering what ATRA and its members think of them,” added Joanne Doroshow, executive director of the Center for Justice & Democracy, a national consumer-rights organization exclusively dedicated to protecting the American civil justice system. “[ATRF’s] members include America’s worst industries (oil, chemical, insurance and pharmaceutical) that have a direct financial stake in restricting lawsuits. What ATRA really seems to hate is our system of government where judges and juries cannot be wined, dined and bought-off by corporate lobbyists like them. So they try instead to issue reports like this, throwing jurisdictions in and out for their own political reasons, and attacking judges and juries who are doing their jobs on behalf of everyday hard-working Americans.” ATRA president Tiger Joyce promised that his organization will continue to rank Judicial Hellholes and dismisses the notion that its intention is to intimidate. “We still intend to write summarizing, year-end reports that rank the Judicial Hellholes, note lesser offending jurisdictions and applaud civil justice reforms and other positive news,” he said. “But we’ve simply decided that the Judicial Hellholes program will be a much more valuable tool for the media, policymakers and the public if its content is regularly freshened and made available online throughout the year. “Remember, the Judicial Hellholes report is not all bad news. Our ‘Points of Light’ section celebrates positive civil justice developments. This year’s report, for example, recognizes Florida’s legislature for passage of three significant tort reforms; West Virginia Circuit Court Judge Arthur Recht for safeguarding the integrity of asbestos claims; and Maryland’s highest court for upholding reasonable limits on awards for noneconomic damages.” The 2010/2011 Judicial Hellholes report names civil courts in Philadelphia; California's Los Angeles and Humboldt counties; West Virginia; South Florida; Cook County, Ill.; and Clark County, Nev., as the worst in the nation. Madison County, Ill.; Atlantic City, N.J.; St. Landry Parish, La.; the District of Columbia; New York City and Albany, N.Y.; and St. Clair County, Ill., made the Judicial Hellhole Watch List, while the Michigan Supreme Court, St. Louis Circuit Court Judge Angela T. Quigless and the Colorado Supreme Court received Dishonorable Mentions. The Florida Legislature, West Virginia Judge Arthur Recht and the Maryland Supreme Court were named to the Points of Light list.

November 29, 2010 by matray

side note: In the article below, the author examines scenarios where the 2010 Healthcare Reforms will ultimately undermine the profitability of the medical professional liability insurance industry. It also looks at possible opportunities that will come with the new reforms. The medical professional liability insurance industry faces new challenges from both health reform and increased competition. A new industry study by Conning Research & Consulting claims that both health care reform and heightened competition will slow growth and profitability for the sector in the future. "The medical professional liability insurance industry is headed for lower profits and slower top-line growth. This has been a highly cyclical line of business, and cyclical conditions are continuing," said Jeffrey Thompson, analyst at Conning Research. "Two forces may drive this line of insurance back into unprofitable waters --competition and an increase in loss costs." Competition is already impacting market conditions with price-cutting, acquisitions, new entrants, and continued growth of self-insured vehicles, Thompson says. "Loss cost growth has been slower to develop, but we believe a number of conditions are aligning for this to take off." The Conning Research study, "Medical Professional Liability in a Changing Health Care Environment: The New Story Unfolds," analyzes the impact of national health reform on an already stressed medical operating environment. The study also looks at opportunities from these changes, including recommendations for new risk management practices and services, changes in the pricing model, product development, and prospects for new markets to emerge. "The delivery of health care is changing and this will change the way medical professional liability insurers view and manage risk, defend claims, manage data, price policies, choose markets, and expand," said Stephan Christiansen, director of research at Conning. "While we see a deteriorating environment for medical professional liability, tools do exist for better-informed companies to drive future performance apart from industry results. No insurer is immune from market forces, yet the degree to which they can insulate themselves is likely greater than they believe." Read more: http://www.insurancejournal.com/news/national/2010/11/29/115228.htm#ixzz16htAmbkg

October 26, 2010 by matray

side note: The acquisition of Michigan-headquartered AP Capital positions California-based The Doctors Company to better compete in the Midwest. Consolidation and growth. The Doctors Company, the largest national insurer of physician and surgeon medical liability, today announced that it has completed its acquisition of American Physicians Capital, Inc. (AP Capital), the parent company of American Physicians Assurance Corporation (American Physicians), a major provider of health care liability insurance in Michigan, Ohio, Illinois, and New Mexico. With the addition of more than 7,000 physician policyholders, The Doctors Company further expands its position as the largest national insurer of physician and surgeon medical liability to almost 55,000 member insureds. “The combination of these two physician-founded companies strengthens our ability to defend, protect, and reward the practice of good medicine,” said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company. “We are pleased by the enhanced value that The Doctors Company will be able to offer physicians, including unparalleled service, exceptional financial strength, and outstanding policyholder benefits. Among those benefits is our unrivaled Tribute® Plan, which rewards physicians for their loyalty to The Doctors Company and to the practice of good medicine.” Upon renewal into The Doctors Company, physicians insured by American Physicians will automatically participate in the Tribute Plan. In connection with the closing of the transaction, AP Capital’s common stock is being deregistered with the Securities and Exchange Commission and delisted with NASDAQ, and public trading of AP Capital’s securities will cease trading at the close of the market today. AP Capital will function as a wholly owned subsidiary of The Doctors Company, and its operations are being integrated with the company’s existing operations. The company will continue to maintain AP Capital’s East Lansing, Michigan, and Albuquerque, New Mexico, offices. see press release

October 25, 2010 by matray

side note: Politics at its lowest are at play in Illinois. Special interest groups looking to remove Justice Kilbride for his recent ruling that declared Illinois tort reforms unconstitutional, are using negative, questionable attack ads that question his toughness on crime. Rather than resorting to faceless businesses making questionable attacks, why don't we try to educate the electorate on the benefits of tort reform and write laws that pass constitutional muster? In a visceral and well-funded attack on Illinois Supreme Court Justice Thomas L. Kilbride, radio listeners throughout Illinois can hear actors portraying the state's nastiest criminals explain how the judge sided with them over their victims. "I was convicted of sexual assault on a woman and her 10-year-old daughter," says the actor playing Paul Runge, the last of three heinous felons featured in the campaign ad. "Then I slashed their throats and burned them. … Unfortunately for felons like us, other justices overruled Kilbride and our convictions stood." The radio spot portraying Kilbride as soft on crime is part of a coordinated campaign by business interests trying to make the Democrat the first Supreme Court justice in state history to lose a retention vote for another 10-year term. Register and receive free newsletters and alerts >> While the campaign focuses on what Kilbride calls "gross distortions" of his record in criminal cases, the real aim of the Illinois Civil Justice League is to dump a judge they see as unwilling to stop large jury awards given to plaintiffs in malpractice and other negligence lawsuits. continue reading

October 25, 2010 by matray

Connecticut recently enacted a law that requires parties in a medical malpractice action to attend at least one session of mandatory mediation before moving forward with the lawsuit. The mandatory mediation requirement was included in a broader patients’ rights bill (SB 248) signed by Gov. M. Jodi Rell. Under the new law, the presiding judge is required to refer medical malpractice cases to a 120-day period of mediation, or another form of alternative dispute resolution (ADR) of the parties’ choosing. The mediation must be completed before the close of pleadings, which generally occurs after the complaint and answer have been filed with the court. The law also requires the mediation session occur within 20 business days after the initial referral and be overseen by the presiding judge or another designated judge. The law stipulates that if the parties do not come to an agreement by the end of the first session, they have the option of moving forward with additional mediation sessions or returning to court to resolve their dispute. In cases where the parties choose to move forward with mediation, the presiding judge must refer the case formally to mediation, which must be overseen by a Connecticut-licensed attorney experienced in medical liability actions. Even if the parties agree to attend additional mediation sessions, they can still abandon the mediation at any time and return to the traditional litigation process. If the parties come to an agreement on any of the issues before returning to court, they can stipulate to these matters in the court case. The cost of mediation is split equally between the plaintiffs and defendants. The mandatory mediation measure was passed in-part due to pressure from the Connecticut medical community. Concerned about rising medical malpractice insurance premiums, doctors, hospitals and defense lawyers lobbied the state to take action to limit the number of meritless medical liability claims. While the medical community preferred to see the legislature create health courts or implement caps on medical malpractice jury awards, mandatory mediation became the compromise. The mandatory mediation law comes seven years after the Connecticut General Assembly passed a similar law to help reduce medical professional liability insurance premiums and meritless legal claims. In 2003, the state legislature passed a law requiring those wishing to file a medical malpractice suit to first obtain a certificate of good faith from a healthcare professional—with similar training as the healthcare provider named in the lawsuit—maintaining that there is evidence to suggest malpractice has occurred. Statistics show that the number of medical malpractice actions filed in the state decreased once certificates of good faith became a requirement. Proponents of mandatory mediation hope the new ADR law will provide similar results and further help reduce the number of medical liability lawsuits in Connecticut. Both plaintiff and defense lawyers are skeptical that the mandatory mediation law will have much of an impact on the rate of settlement of medical malpractice claims. One of the biggest potential problems with the law is the timing of the mediation. Legal commentators say that requiring the parties to attend mediation so soon in the legal process—before the close of pleadings—is too early. They argue that at this stage in the process, discovery has not begun, expert witnesses have not been deposed and the true value of the case generally is unknown. They contend that asking victims of medical malpractice to accept a settlement before the true extent of their damages has been determined is simply unfair. Additionally, hospitals or physicians admitting to negligence so early on is unlikely. This is particularly true for doctors who may face other repercussions for admitting to medical malpractice, including reporting the act to the state Department of Public Health and facing possible disciplinary action. Moreover, most medical malpractice insurance policies include a “consent to settle” clause that requires the insurer to gain the approval of the physician prior to agreeing to a settlement. Thus, if the doctor is unwilling to settle so early in the case, then mediation cannot be successful.