October 2003 Bulletin

In Brief


The California legislature passed a dramatic overhaul of the state worker’s compensation system. The new law’s aim is to reduce the amount of money paid for medical care under the system. To that end, the bill creates a fee schedule at 120 percent of Medicare for outpatient surgical centers, requires an aggregate five percent reduction in the physician fee schedule (procedures currently at or below Medicare cannot be reduced), mandates utilization guidelines, limits chiropractic and physical therapist visits to 24 per claim, allows employers to get a second opinion before spinal surgeries, and reduces the time medical providers must be paid from 60 to 45 days (15 days for electronic claims). The bill will allow self-referral to outpatient surgical centers with disclosure (earlier versions would have banned such self-referral). For more information, visit Web site.


The Florida Medical Association is pursuing a signature collection campaign to bring before voters a proposed amendment to the state constitution that would reduce attorney’s fees in medical liability cases. The measure would ensure that patients receive 70 percent of the first $250,000 awarded, and 90 percent of any remaining amount. For more information, visit Web site.


The state of Maine required Anthem Blue Cross to pay $350,000 in fines for prompt pay violations and reimburse 387,000 providers $1.2 million in interest that was not paid.


A bill passed earlier in the year eliminated joint and several liability for defendants found to be less than 50 percent at fault. Previously the threshold had been 15 percent at fault. For more information, visit Web site.


During their veto session, senators failed to override Gov. Holden’s veto of the tort reform bill that would have lowered the cap on non-economic damages to $350,000. The vote on the motion to override fell two votes short of the 23 votes needed for passage. For more information, visit Web site.


The Nevada state Supreme Court has upheld an $11 million award in a medical liability case, the largest ever in the state’s history. The original jury award was $764,000 for medical costs and $8 million in damages, but interest increased the total to $11 million during the appeal process. For more information, visit Web site.

North Carolina

Governor Michael F. Easley signed a bill requiring insurers to disclose their fee schedules and claims submission and reimbursement policies to providers. The bill also requires insurers to notify providers if any changes will be made to their fee schedule and claims submission or reimbursement policies.

At the end of the session, the North Carolina Senate rejected an attempt to add language creating a cap on non-economic damages to an unrelated bill. The Senate Committee that is meeting to discuss this issue has produced a draft bill that does not contain any caps. The draft bill does allow the judge to review any jury awards greater than $250,000. For more information, visit Web site


A bill passed both houses that lowers the post-judgment interest rate to five percent or the federal discount rate plus three percent, whichever is lower.

Another bill was signed by Governor Ted Kulongoski to create the Oregon Patient Safety Commission. The Commission will “establish a confidential, voluntary serious adverse event reporting system to identify serious adverse events.” It will also “establish quality improvement techniques to reduce systems’ errors contributing to serious adverse events and disseminate evidence-based prevention practices to improve patient outcomes.” For more information, visit Web site


In an important victory for physicians and patients, voters approved a constitutional amendment that allows the legislature to cap non-economic damages. There was intense campaigning on both sides. Turnout was high and the vote was close. The amendment passed 51 percent to 49 percent.

Earlier in the year, the legislature passed a bill that would cap physician liability for non-economic damages at $250,000. In a sign that the physicians’ efforts will be successful in addressing the crisis, the Texas Medical Liability Trust, which insures one third of the physicians in Texas, promised that they would lower rates by 12 percent on January 1, 2004, if the amendment passed.

The AAOS has collected resource materials on the medical liability insurance crisis in the states, including state tort laws, the AMA crisis map, talking points, issue briefs and sample brochures.

Want to learn more about the state legislative scene?

You can access state legislative home pages and view state and local government indices and monthly legislative roundups for years 2002 and 2003 by visiting the AAOS Web site and clicking the appropriate link.

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