The Medical Board of California is posting information on physicians who have been accused of negligence or subject to disciplinary actions on a new Web site. Eventually, as many as 15,000 documents covering license revocations and letters of reprimand may be posted. The California Medical Association has requested that the Board add a disclaimer noting that some of the information has not been substantiated.
Hospitals have a three-year reprieve to meet strict nurse staffing ratios. Hospitals will have until Jan. 1, 2008 to achieve a staffing ratio of five patients for each nurse on general medical/surgical wards. The current mandated ratio is six patients per nurse. State officials say the nurse-to-patient ratios have led 11 hospitals to close or eliminate staff-intensive departments such as emergency rooms and psychiatric wards.
Georgia state legislators are planning a “common sense agenda” for 2005 that includes significant tort reform. The General Assembly will convene in January, and medical liability reform measures include legislation that encourages out-of-court settlements and an aggregate cap on noneconomic damages of $750,000.
Maryland physicians, facing a 33 percent increase in medical liability insurance premiums, are continuing to press state legislators to address two key issues: how to pay for a proposed state reinsurance fund and what limits might be placed on noneconomic damages in medical liability lawsuits. A report by the Maryland Hospital Association noted that the rising premiums are having an effect on the state’s economy. Reduced spending has resulted in the loss of 1,850 jobs this year and about $171 million in lost business sales.
A report by the Massachusetts Board of Registration in Medicine notes that female doctors are far less likely to be sued or forced to pay large settlements than their male colleagues. The report said that about 31 percent of the state’s physicians are women, but women account for only 16 percent of medical liability claims and settlements over the past 10 years.
The largest medical liability insurer in Michigan is launching a contest to reward doctors who make an extra effort to avoid lawsuits. American Physicians Assurance Corp., which covers about 20 percent of physicians in the state, will recognize physicians who implement office practices that ensure patients get quality care and reduce the risk of lawsuits.
The Pennsylvania state legislature has extended subsidies to 30,000 physicians and other health care providers under the state’s MCare program. The measure passed both houses unanimously and exempts orthopaedic surgeons and other high-risk specialists from paying an MCare assessment, adds podiatrists to the list of covered physicians and pays half of the assessment for most physicians (including podiatrists). Physicians who accept the subsidy must stay in the state through the end of the following year.
Gov. Phil Bredesen has agreed to one more round of negotiations with patient advocates, but the possibility that TennCare, the state’s health care plan for its most vulnerable residents, may be dismantled remains. In 1994, TennCare replaced Medicaid for state residents not covered by other health insurance. Once hailed as a model for the nation, the program now consumes nearly a third of the state’s budget and faces a potential deficit of $650 million. Nearly 25 percent of the state’s population is covered by the program.
An appeals court ruling has given the Texas Orthopaedic Association and the Texas Medical Association standing to sue the Texas State Board of Podiatric Medical Examiners over a ruling that expands podiatrists’ scope of practice. Physicians are challenging the podiatric board’s authority to adopt a rule defining the foot as “including the tibia, fibula in their articulation with the talus and all bones and toes, inclusive of soft tissues that insert into the tibia and fibula in their articulation with the talus and all bones to the toes.”
The Utah state Supreme Court has upheld the state’s cap on noneconomic damages in the case of a six-year-old boy with brain damage. The original jury had awarded $1.25 million, which the judge reduced to $250,000 in accordance with the law. The justices wrote that the cap was a “policy choice made by the legislative branch, and we cannot say that it is unconstitutional.”
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For specific information on medical liability reforms at the state level and the results of ballot measures in November, see the article on page 44.
To learn more about the state legislative scene, access state legislative home pages, view state and local government indices and review monthly legislative round-ups prepared by the AAOS department of socioeconomic and state affairs on the Academy web site.