October 2002 Bulletin

In Brief

Both houses in California passed Assembly Bill 2907 to create the "Health Care Providers Bill of Rights." Under the bill, provider contracts cannot be materially altered without negotiation and agreement between the plan and the provider, nor can providers be forced to accept more patients if doing so would endanger access or continuity of care. Plans must give providers 15 days notice before asking for compliance with quality improvement or utilization management programs.

The California Legislature approved S.B. 1950 requiring some public disclosure, for the first time, of doctors’ medical liability settlements. The bill is headed to Gov. Gray Davis for action and would require the Medical Board of California to disclose information about physicians’ settlement history—in addition to education and license status—to help patients research doctors.

If the measure becomes law, the medical board would be required to publish settlements of $30,000 or more on its Web site if a physician in a low-risk specialty such as family practice has three or more settlements—but would not be allowed to disclose the dollar amount of settlements and would only state whether the settlement is below average, average or above average compared with other doctors in the same specialty. For high-risk specialties, the threshold is four settlements. The bill would only apply to settlements made after Jan. 1, 2003. Among other provisions, the legislation would require the medical board to give priority to investigations of cases in which a patient was harmed or died as a result of perceived physician misconduct. Information on these bills can be found online at http://www.sen.ca.gov.

H.B. 6004 passed during a special session requiring the state to provide "within Medicaid appropriations" reimbursement increases to physicians who provide services to dual eligible patients.

Gov. Jeb Bush created the Select Task Force on Healthcare Professional Liability Insurance on August 28 to examine how the state’s high medical liability insurance rates are affecting health care and to make recommendations on how to control the skyrocketing cost of medical liability insurance. Health care liability insurance rates in Florida have increased an average of 30 percent during the past two years with further increases expected, according to the Governor’s office. Doctors have asked the legislature for limits on jury awards in liability suits. The charges of the Select Task Force can be seen at http://sun6.dms.state.fl.us/eog_new/eog/orders/2002/august/eo2002-241-08-28-02.html.

The Hawaii Medical Association (HMA) continued the trend of state medical societies filing suit against payers for unlawful and deceptive trade practices for underpaying physician claims. The HMA sued Hawaii Medical Services Association, a managed care provider. The complaint alleges failure to pay claims in a timely manner, unsupported overruling of physician medical necessity decisions and illegal downcoding and bundling of claims. HMA’s lawyers also represent medical associations in lawsuits in Connecticut, New Jersey, New York, South Carolina and Tennessee. For updated information visit the HMA’s Web site at http://www.hmaonline.net.

Editor’s Note: The Bulletin wishes to apologize for an editing error in an item about Hawaii in the June issue. It may have appeared that a bill in Hawaii expanding the chiropractic scope of practice had been signed into law. In fact, subsequent to the publication of that issue, Gov. Cayetano vetoed the bill. We regret any confusion due to the error.

Governor Ryan vetoed legislation, H.B. 2271, to create the Medicaid Hospital and Physician Payment Task Force that would have studied Medicaid payment rates to physicians and hospitals. The bill’s text can be found at http://www100.state.il.us/government/gov_legislature.cfm.

The House and Senate passed different versions of a medical liability reform bill—House Bill 2c—during a special session, but have not yet reached a compromise on final language of the bill. The bill, as passed by the Senate, has a $250,000 cap on non-economic damages, while the House version has a $1,000,000 cap with an escape clause allowing higher non-economic damages if the judge determines they are necessary. The Senate version includes a state run liability insurance pool for doctors, while the House bill does not. The two bodies also disagree on venue reform and the elimination of joint and several liability. Updated information on H.B. 2c can be found online at http://www.ls.state.ms.us/.

New Jersey
S.B. 1680 was signed into law in August requiring medical liability insurers to report to the state information on physicians, podiatrists or nurses whose premium renewals, on or after January 1, 2002, increased by 30 percent or more. To view the language of the bill, visit the state Web site at http://www.njleg.state.nj.us/2002/Bills/AL02/55_.HTM.

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