A pilot malpractice docket for medical liability suits and a “patient safety center” to help prevent medical errors are among the final recommendations offered by a commission chaired by Ohio Insurance Director Ann Womer Benjamin.
Six states have established patient safety centers, with a general mission of coordinating patient safety efforts, identifying and educating health care providers about medical best practices, and developing data collection systems and protocols for error reporting. The Ohio Medical Malpractice Commission’s report states that such a center in Ohio should be structured as a partnership among state government units and appropriate private institutions. The report said that while several patient safety initiatives are being pursued in Ohio, the establishment of a central authority is critical.
Commission members heard substantial testimony on the viability of binding arbitration, pretrial screening panels and medical review boards. The report indicates that many issues are unresolved regarding these proposals, including whether they are constitutionally feasible, reduce costs or save time. The commission’s report recommends a pilot project in one or more counties that establishes specialized medical malpractice courts or dockets.
The commission’s report also recommends that the tort reforms comprising Senate Bill 281 remain in effect in Ohio with the expectation that it will help to stabilize the medical malpractice market over time. Testimony of insurance department representatives from Indiana, Wisconsin, and New Mexico and data from other tort reform states indicate the positive impact tort reform has had on other states’ markets, which have sustained relative market stability compared to non-tort reform states.
In addition, because rates primarily rely on loss experience over a period of time and the fact that most medical malpractice cases now being heard in Ohio courts are not subject to S.B. 281, the Commission could not conclusively evaluate the effects of the new law on the Ohio market, or on medical malpractice cases in Ohio.
The report also recommends the following:
—The Ohio Department of Insurance require medical malpractice companies to file and justify their rates, even if no change is requested, at least once every year;
—The new data collection provisions of House Bill 215, OAC 3901-1-64, and HB 425 be evaluated annually after each annual cycle of data has been collected. The annual report by the Department required by HB 215 should provide the basis for this evaluation;
—The investigation of programs to forgive educational loans and other incentives for doctors in certain specialties and for those doctors who agree to stay in Ohio for a specified period of time;
—That no further action on a Patient Compensation Fund, funded solely by health care providers, be taken at this time;
—The Department continue to investigate captive formation in Ohio, which could result in related legislation;
—The issuance of guidelines by the Ohio Department of Insurance which would require medical liability insurance carriers to incorporate into their underwriting and pricing of policies for free clinics appropriate modifications to reflect past and prospective claim experience in Ohio;
—The inclusion of free clinics in a statewide medical error reporting system in order to ensure that patients are receiving the best care possible;
—The Commission does not recommend a change in the rate review system in Ohio, finding that rates are well regulated.
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