STATE LEGISLATIVE UPDATE

April is the time of year when many state legislative sessions come to an end, and many of the bills tracked either become law or fade away. This April saw new laws passed on aspects of tort reform, insurance reform, allied health professions, and specialty hospitals.

As of April 29st, states currently in regular session are AK, AL, CA, CO, CT, DC, DE, IL, KS, LA, MA, MI, MN, MO, NC, NE, NH, NJ, NV, NY, OH, OK, OR, PA, RI, SC, TN, TX, and WI. States currently having special sessions are California and Maine. This year, as of March 31st, 136,707 new bills have been introduced in the states, and 18,746 of those 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 contact Bruce Allain at allain@aaos.org (or at 847-384-4336).

TORT REFORM

As seems to be a pattern this year, the biggest news from this month is once again a major tort reform victory. In April, South Carolina saw tort reform legislation signed into law. Among other things, the new law caps noneconomic damages at $350,000 per defendant, and in cases with multiple defendants, limits the total a plaintiff can collect in noneconomic damages to $1,050,000. It also requires parties to participate in mediation before a case goes to trial, and creates new rules to determine who can testify as an expert witness.

Arizona also had some tort reforms become law. The new law limits those who can testify against doctors in medical malpractice claims to individuals who practice in the same area as the physician being sued. In addition, if the defendant is board certified in a specialty, the witnesses also must be certified by the same board. The law also has a provision that enables health care providers to offer apologies, sympathy, commiseration, and compassion to patients without fear that the providers' statements could be used against them in a malpractice action. Legal experts though, including the Governor, are concerned that the law will be struck down as unconstitutional.

Also, Montana enacted legislation that restricts the amount of damages that can be awarded for a reduced chance of a patient’s recovery.

INSURANCE

Arkansas passed a lengthy law relating to insurance reform. Among the extensive provisions of the bill is a section stating that rates for malpractice insurance cannot be excessive, and helps to define what excessive means. Insurance reform was also passed in Arizona, with a law that addresses some prompt payment problems, grievance procedures, and payments to noncontracted providers. Health providers in Maine can now simultaneously submit claims to all insurers potentially liable for payment, thanks to a new law which also requires insurers to pay or deny claims within 30 days. In addition, legislation requiring prompt payment was passed in Nebraska; the new law also allows the state to punish insurers who engage in unfair payment patterns.

PHYSICAL THERAPY

A bill was introduced in North Carolina this month which would allow physical therapists to be disciplined for financially compensating another for referring a patient. This language is similar to that being used by APTA in South Carolina to try to prevent physician owned physical therapy services and physician employment of therapists.

North Dakota had a bill pass that expanded the definition of the practice of physical therapy to include such things as examining, evaluating and testing individuals in order to determine a diagnosis for physical therapy.

SPECIALITY HOSPITALS

A new law in Montana requires specialty hospitals to be licensed by the department of health and human services, and enacts a moratorium on the licensure of specialty hospitals until July 1, 2007. A moratorium on specialty hospitals was also enacted in Washington lasting until July 1, 2006.

PODIATRY

The podiatrists scored a victory in Idaho this April with the passing of legislation that expands the scope of practice for podiatrists to include the ankle and those soft tissue structures below the knee governing the function of the foot and ankle. Furthermore, language forbidding podiatrists from amputating the foot was struck from state law. Massachusetts has recently seen legislation that also would expand the scope of practice for podiatrists to include ankle surgery.

MISCELLANEOUS

In addition, Massachusetts is the latest state to see diagnostic imaging legislation introduced. The bill being considered would make it illegal for a nonradiologist physician to refer a patient for services at an MRI, PET or linear accelerator that the physician has an ownership interest in.

The state of Virginia passed a law strengthening that states lawsuit immunity for reporting on the conduct or competency of health care practitioners.

A bill has been introduced in Louisiana that would benefit the chiropractors. The new bill, if passed, would prevent insurance companies from requiring a referral for services performed by a chiropractor if a referral is not required for physicians providing the same service.