Maryland Scraps Major Med-Mal Reform; Limited Proposal Gets Preliminary Approval in House

March 29, 2004

A limited medical malpractice bill that may be the Maryland legislature’s only response to a perceived crisis in health care was given preliminary approval by the House on March 27.

It would set up a task force to study problems caused by big increases in malpractice insurance premiums and recommend what the state should do to hold down the cost of insurance for doctors, hospitals and nursing homes.

The bill also makes some modest attempts to cut insurance costs, including allowing judges to deduct from damages awarded to patients any health care costs they have already incurred that were paid by their insurers.

The bill needs a final House vote before moving to the state Senate with just two weeks left in the 2004 General Assembly session.

A bill creating a registry that would guarantee unmarried couples the right to make medical decisions for their partners also got preliminary approval after the House made a major change to expand it to include all unmarried heterosexual couples.

The bill as it reached the floor in Annapolis applied only to same-sex couples and to couples over 62, who were included by the committee because older people can face significant tax and estate problems if they get married.

Other heterosexual couples were excluded because they can get married, but the House voted 69 to 62 to include everyone.

The Medical Decision Making Act creates a registry with the state Department of Health and Mental Hygiene. Unmarried “life partners” who register would be guaranteed the right to visit each other and could not be excluded from medical decisions.

The medical malpractice proposal is a far cry from the comprehensive approach requested by the health care industry and proposed by Gov. Robert Ehrlich.

A key part of Ehrlich’s plan was a proposal to reduce the cap on noneconomic damages — commonly called pain and suffering — from $635,000 to $500,000. Another important element in his plan would have required awards for economic and noneconomic damages of more than $250,000 to be paid out over a period of years instead of by an upfront, lump sum payment, reducing the overall cost of the award to insurers.

But that plan was killed in the Senate, and little remains in the House bill that was discussed March 27.

Kenneth Masters, Ehrlich’s chief legislative officer, said the deduction of previous health care costs that was covered by insurance will save some money for malpractice insurers, “but that’s not the large awards that are driving our malpractice crisis.”

“It really doesn’t look like there’s going to be much coming out of the session,” he said.

Delegate Anthony Brown, D-Prince George’s, defended the decision to scrap most of the proposed changes offered by the health care industry in lieu of a bill that is mostly a study of the problem that would result in a report to the legislature next year.

“There are a lot of complicated issues, too complicated to understand the mechanics and impact” of the proposed solutions during the short time remaining in the session, Brown said.

The health care industry conducted a major lobbying campaign this year, including a rally in January attended by more than 2,000 doctors asking for relief from soaring malpractice insurance premiums.

Some physicians, especially those in high-risk specialties such as obstetrics and neurosurgery, say that have curtailed their practices or stopped seeing patients because they can’t afford to pay malpractice insurance premiums.

Representatives of the health care industry attribute the increases to steady a growth in malpractice awards by juries, a trend they say must be curtailed.

But defense lawyers, who opposed the bills, argued that reduced earnings on investments resulting from the long stock market slump are responsible for the higher premiums, not the cost of malpractice settlements.

Copyright 2004 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed

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