STATE LEGISLATIVE UPDATE

APRIL 2004 STATE LEGISLATIVE UPDATE

As the presidential race heats up a recent poll by health insurance companies found that 30% of voters in the 17 key battleground states thought controlling costs was the number one issue in health care that will affect their vote. For a toolkit on medical liability reform please visit www.pactproject.org.

As of the end of the month, the following state legislatures were in regular session: AK, AL, AZ, CA, CO, CT, DE, HI, IL, KS, LA, MA, MI, MN, MO, MS, NH, NJ, NY, OH, OK, PA, RI, SC, TN, VT, and WI. In April the legislatures in FL, GA, IA, ID, KY, MD, and NE adjourned. Through April there have been 102,157 bills introduced in the states in 2004 and 14,144 have become law.

Some of the bills the Department of Socioeconomic & State Society Affairs is tracking are outlined below. If you have any questions please give Jay Fisher a call at 800-346-2267, x4336.

TORT REFORM

The tort reform bill in Alaska to lower the cap on non-economic damages to $250,000 was amended in the House to basically restore the current $400,000/$1,000,000 cap (the higher cap is for cases of severe injury). The bill in Colorado allowing a judge to override the hard cap on economic damages if past economic damages are greater than $1,000,000 and if applying the cap would be unfair was signed by the Governor. In Georgia the Senate first voted for a $250,000 cap and then struck the language on reconsideration. When the bill was in conference committee the Senate conferees wanted to insert the $250,000 cap, but the House conferees refused and no bill passed before adjournment.

Legislation to create a $250,000 cap on non-economic damages first failed by one vote in the Iowa Senate and then passed 27-21 on reconsideration. The bill is expected to be vetoed by Gov. Vilsack. In Illinois physicians held a large rally at the statehouse advocating for relief, including a cap. Despite the fact that his wife's OB has closed her practice, Gov. Blagojevich and the Democrats in the legislature are not expected to support a cap. In Mississippi, the House continues to oppose lowering the cap to $250,000, but has voted to keep alive a reform bill. Gov. Barbour has threatened a special session to lower the cap. A bill to create mandatory pre-trial screening panels passed the New Hampshire Senate and now goes back to the House.

In Connecticut The House voted down, 81-63, an amendment to add a cap to the tort reform bill. The bill is now in the Senate and includes an affidavit of merit requirement, mandatory mediation, insurance rate reform and allows a judge to review non-economic damage awards over $1,000,000. Governor Rowland has threatened to veto any bill without a cap.

After legislation passed both houses in Missouri the Governor vetoed it. As passed, the bill tightens venue in all tort cases, restricts joint and several liability, lowers the cap on non-economic damages from $565,00 to $400,000 and eliminates the inflation adjustment, overturns the Missouri Supreme Court case that led to multiple caps applying to one case, caps non-economic damages in trauma cases to $200,000, and requires periodic payment of future medical damages. In his veto message Governor Holden stated that he would sign a bill that includes insurance reform, lowering the cap on non-economic damages, overturning the Supreme Court case and requiring affidavits of merit. The Governor wants a bill that is limited solely to medical liability reform. The bill passed easily, but was just short in each house of the votes needed to override a veto. In Maryland, after the legislature adjourned without addressing the growing crisis, the Governor stated that if premiums continue to rise this summer he would call a special session to address the issue.

PHYSICIAN OWNERSHIP OF HEALTH CARE FACILITIES

After beating back an attempt earlier in the session by hospitals to outlaw self-referrals to specialty hospitals and ASCs physicians in Colorado successfully shelved another bill that would have required any procedure requiring a length of stay over 23 hours be performed only in a general hospital. This was an attack on recovery/convalescent care centers.

SCOPE OF PRACTICE

Legislation was introduced in Michigan to allow physical therapists direct access to patients without a physician referral. In other PT news, the Attorney General of South Carolina recently issued an Opinion interpreting the S.C. PT statute to mean that it is a disciplinary offense for a PT to be employed by a physician. There was also a bill introduced in Illinois this session that would incorporate language into the PT statute to make it a disciplinary offense for a PT to accept a referral from a physician from whom they accept a salary or from a physician who has a financial interest in the PT practice. This language has been struck from the bill, however. Be on the lookout for similar bills in the near future, as this seems to be a national attempt to prevent PTs from being employed by physicians.

Legislation passed the House in Tennessee dealing with podiatrists who were credentialed to perform ankle surgery at JCAHO-accredited hospitals or ASCs before 1995. The existing statute requires all podiatrists to be certified by the American Board of Podiatric Medicine in ankle surgery by 2005. This bill eliminates that requirement for these particular podiatrists. The bill was greatly improved due to the negotiating of orthopaedists in the state. The Tennessee Governor signed legislation requiring certification of surgical technologists. A bill requiring licensure for surgical assistants was signed in Kentucky.

PROMPT PAYMENT

New York fined 21 health plans a total of $212,300 for prompt pay violations. The Colorado Governor signed a bill designed to make it harder for Medicaid to delay payments to physicians. A bill was signed in Maryland to amend the prompt pay statute to replace "pay" with "mail or transmit payment" to counteract insurers who cut a check and then forget to put it in the mail.

PRACTICE MANAGEMENT

Legislation has passed both houses in Florida to require HMOs to provide a copy of their fee schedule to physicians and to inform physicians of changes to the schedule. A ban on gag causes in insurance contracts was signed in Virginia.