My Medical Malpractice Insurance

June 17, 2010

Federal Government Seeks Power To Exclude Those Involved With Health Fraud From Working Again With Medicare

Filed under: Insurance — Tags: , , — Mike @ 8:36 am

side note: This blog maintains its focus on medical professional liability insurance and medical malpractice, but this article was such an eye opener this morning, we had to share.

The Hill: “Independent federal investigators hoping to rein in Medicare fraud are asking Congress for broad new authority to boot offending corporate executives from the insurance program. The change is designed to control Medicare claims fraud by punishing culpable owners, managers and other corporate higher-ups, and not just the convicted companies. … Under current law, HHS can exclude from all federal healthcare programs any owner or employee who knew, or should have known, about a healthcare scheme leading to a company’s conviction. But to be subject to the exclusion, the offending person must still be with the company.” As a result, “[c]ulpable executives can resign – and offending owners can divest – immediately after a company’s conviction”, leaving Office of the Inspector General officials without power to prevent them from “participating in federal health programs with other companies. OIG wants Congress to expand its exclusion authority to include any worker – past or present – found responsible for the fraud” (Lillis, 6/15).

The Boston Globe: A federal official told Congress Wednesday that some of the new Medicare models for reimbursing doctors and hospitals, such as those using “bundled” payments or flat fees for specific conditions increase “the danger” that providers could “cheat patients and the government by skimping on care. … The Office of Inspector General is developing plans to scrutinize new models of care to block fraud opportunities, said [Lewis Morris, chief counsel for the Office of Inspector General in the Department of Health and Human Services]. The new health care overhaul law signed by President Obama this year, he added, gives OIG investigators better tools to scrutinize Medicare computer data in a hunt for fraud” (Rowland, 6/15).
(more…)

June 9, 2010

Medical Professional Liability Insurance Execs: We Must Be Flexible Amid Health Reform

side note: This sounds like it was a fascinating seminar. I wish I had been in attendance.

Yes, The Obama Administration’s big victory healthcare reform has little, if any, direct impact on the medical professional liability industry. Specifically, the industry’s anti-trust exemption—once under attack—will remain intact. But what effect will adding 30 million new patients to the system do to liability projections?

National health reform will not have direct impacts on the business of medical professional liability insurance, but carriers should be ready to adapt to changing conditions caused by its ripples through the health sector, agreed a panel of insurance executives at the Oppenheimer CEO Summit.

The coming expansion of insurance coverage for a projected 30 million more Americans will hopefully lead to a shift from emergency-room care to physician offices for nonurgent medical events, ProAssurance President Vic Adamo said. While much is uncertain, that change coming is certain, he said.

“That’s seven Alabamas coming on line. That’s three New Jerseys. It’s massive,” he said.

The panel, “Medical Malpractice: What is the Current State of the Market for Medical Malpractice Insurance?,” included Adamo, FPIC Insurance Group Chief Executive Officer John R. Byers, Americans Physicians Service Group Chief Operating Officer Timothy L. LaFrey and American Physicians Capital Chief Financial Officer Frank Freund.

More physicians are moving to hospitals and large provider groups, Byers said. There may be more opportunities for insurers in providing coverage for those groups, Freund added.

“Being flexible and adaptive there is really the key,” Freund said.

Another significant issue for medical professional liability insurance writers is the future of tort reform amid challenging court rulings.
(more…)

May 11, 2010

Reporting surgical fires could improve patient safety in Ohio, experts say

side note: transparency and risk management have long been suggested as a means of lowering medical accidents. The Cleveland Clinic is correct. Accountability and a sharing of mistakes would go far in preventing future mistakes.

When fire breaks out and burns a patient during surgery in Pennsylvania, the hospital is required by law to report the incident to the state Patient Safety Authority.

If a similar surgical fire ignites in New York or California, the hospital must notify the state health departments there.

Read Remaining

And if the same thing happens in Ohio?

The hospital doesn’t have to tell any state agency.

That lack of reporting, experts say, hurts all of us.

That’s because getting the word out about medical errors keeps patients from being injured, cuts down on medical malpractice lawsuits and, in the end, reduces unnecessary health care costs.

“Medical error reporting, in general, helps change clinical practice for the better and helps improve patient safety,” said Mark Bruley, a researcher who has been publishing articles on the causes and prevention of surgical fires for more than 30 years.

On April 30, officials at the Cleveland Clinic confirmed that six fires had broken out in operating rooms in the 12-month period that ended in March.
Patients suffered “superficial burns” in three of the fires, they said. And no one was harmed in the other three.

April 8, 2010

Final Healthcare Reform Bill Signed into Law, Poses Little Impact on Medical Professional Liability Insurance Industry

Washington’s debate over healthcare reform came to an official close on March 25, when the U.S. House of Representatives voted 220-207 to pass legislation that made budgetary “fixes” to the Patient Protection & Affordable Care Act, the 2,409-page piece of healthcare reform legislation signed into law earlier that same week. This final legislation, debated under special rules designed to prevent a filibuster in the Senate, passed that chamber earlier in the day by a vote of 56-43.

There was nothing in the “fix-it” bill that directly affects medical professional liability insurers, although Sen. John Ensign of Nevada had attempted to add a medical liability provision during Senate debate. Specifically, the Ensign amendment would have granted immunity from medical liability lawsuits to anyone providing pro bono care to an individual who was indigent or uninsured, providing the healthcare provider had not committed gross negligence or acted outside the scope of his or her licensure. The amendment was defeated by a straight party line vote of 40-55.

Also missing from the final bill was any language that would repeal medical liability insurers’ longstanding exemption from federal antitrust laws.

Sen. Patrick Leahy of Vermont had once offered an amendment to the healthcare reform bill that would have voided the McCarran-Ferguson Act of 1945—which exempts the healthcare and medical liability insurance industries from federal antitrust laws that apply to most other industries. The amendment once had 18 cosponsors and successfully moved through the Senate Judiciary Committee.

What is in the final Patient Protection & Affordable Care Act is a weak provision that would provide $50 million for grants to states that want to launch “demonstration projects” to test medical tort reform.

According to the bill, individual states that get funds set aside for tort reform demonstration projects will be required to develop an alternative to current tort litigation that allows for the resolution of disputes over injuries allegedly caused by healthcare providers or healthcare organizations; and promotes a reduction of healthcare errors by encouraging the collection and analysis of patient safety data related to disputes by organizations that engage in efforts to improve patient safety and the quality of healthcare.

Critics of the “demonstration project” tort-reform provision in the healthcare bill point to its opt-out clause, which allows any plaintiff to opt out of a program he or she doesn’t like, and pursue his or her claims in state court.

“I am very pleased to report that the healthcare bill is clear of any provisions that would limit an injured patient’s rights concerning medical negligence claims,” crowed Anthony Tarricone, president of the American Association for Justice, the United States’ largest plaintiffs bar, in a letter to his membership. “While some states may embark on demonstration programs we find objectionable, the opt-out provision for plaintiffs minimizes this concern.”

March 17, 2010

e-prescriptions reduce errors, decrease rate of medical malpractice

side note: Here is one of the many benefits to adopting electronic health records and embracing technology as the country moves forward with healthcare.

NEW YORK (Reuters Health) – Doctors who trade in their prescription pads for electronic prescribing systems may be able to significantly cut down on medication errors, a small study suggests.

Researchers found that among 12 New York State primary care practices, the six that had adopted “e-prescribing” systems reduced their prescribing errors by nearly seven-fold over one year. Errors included mistakes like giving patients the wrong dose, wrong duration of use or incorrect or missing usage directions.

Electronic prescribing has been widely seen as a way to improve efficiency, save money and cut medication errors, such as cases where a pharmacy dispenses the wrong drug due to a doctor’s illegible handwriting. The systems also typically provide doctors with a drug’s allergy warnings, potential for interacting with other medications and other information that could help prevent adverse effects.

President Barack Obama has promoted greater use of e-prescribing and electronic patient records as part of healthcare reform, and the economic stimulus package passed last year included funds to encourage more doctors to adopt e-prescribing — which as of 2009, only an estimated 13 percent of U.S. doctors had done.

But it is unclear how the commercially available e-prescribing systems have so far performed in the real world, in solo and small-group medical practices, according to the researchers on the new study, led by Dr. Rainu Kaushal of Weill Cornell Medical College in New York City.

To study the question, the researchers focused on a dozen small practices in a largely suburban and rural area of New York. According to their report in the Journal of General Internal Medicine, half of the practices adopted e-prescribing systems, while the other six stayed with paper prescribing.

Kaushal’s team found that over one year, the e-prescribing practices cut their average prescribing error rate from 42.5 per 100 prescriptions to 6.6 for every 100 prescriptions.

In contrast, practices that stayed with paper saw their error rate remain nearly the same; at the outset, about 37 percent of prescriptions contained an error, and one year later that figure was 38 percent.
(more…)

March 15, 2010

Georgia Supreme Court Upholds ER statute of medical malpractice tort reform

side note: here is a substantial win for the “gross negligence rule” that many state’s tort reforms now include.

The Georgia Supreme Court on Monday upheld a key provision of the state’s tort reform law that makes it more far more difficult for patients to win damages in cases involving emergency room care.

In a 4-3 decision, the court ruled in a challenge brought by a woman who went to the emergency room in Columbus complaining of serious pain behind her eyes. She said a doctor sent her away with a prescription and failed to diagnose her real, disabling illness.

Under the tort reform law enacted in 2005, a plaintiff must establish by “clear and convincing evidence” that an ER doctor committed “gross negligence” to prevail in a lawsuit.

Justice George Carley, writing for the majority, noted the law was enacted amid the medical industry’s claims that medical malpractice insurance rates were soaring.
(more…)

March 8, 2010

Medical malpractice insurance market expected to soften

side note: Wow! I found this to be a surprise. Even with the investment sector still moving in relative chaos, the highly respected Standard & Poor’s Rating Service is forecasting a continued soft market for medical liability insurance. What does this do to the argument that medical malpractice insurance rates are climbing unchecked through the roof?

The medical malpractice insurance market appears likely to soften more, as insurers continue to battle what one ratings service calls “significant challenges.”

Standard & Poor’s Ratings Service is forecasting that the market will continue to soften as prices declined at a more moderate pace.

The ratings service notes that medical malpractice insurance writers apparently achieved better operating results in 2008 and through the first nine months of 2009 than it had forecast two years ago because of
larger-than-expected favorable reserve development.

“Even without the ups and downs of the pricing cycle, medical malpracticeinsurers face significant challenges, including volatile losses, the long-tail nature of the reserves and exposures, and the potential for adverse legal verdicts,” Standard & Poor’s said in a statement. “We have only seen a handful of insurers sustain profitability throughout pricing cycles, and they have generally been the larger, more diversified insurers in a highly fragmented industry.”

The ratings service said it expects many medical malpractice monoline companies to ultimately report a stable or improved combined ratio for 2009, mainly because of reserve releases, a trend it anticipates will continue through 2010 and mitigate the expected decline in prices.
(more…)

March 1, 2010

Sen. Dick Durbin on medical malpractice reform at White House health summit

side note: Here is insight on the medical malpractice debate from the second most powerful member of the Senate majority party.

DURBIN: Mr. President, I’ve been biding my time throughout this entire meeting. I thank you for inviting us on the issue of medical malpractice. Before I was elected to Congress, I worked in a courtroom. For years, I defended doctors and hospitals, and for years I sued them on behalf of people who were victims of medical malpractice. So I’ve sat at both tables in a courtroom. At least many years ago, I think I kind of understood this area of the law better than some.

But I listen time and again as our friends on the other side when they’re asked what are the most important things you can do when it comes to our health care system in America. The first thing they say is medical malpractice. It’s the first thing they say. Today, it was the first thing that was said.

The point that’s been made by the president is if we do believe the Congressional Budget Office, when Orrin Hatch asked them how much will we save if we implement the Republican plan on medical malpractice from the House, they said $54 billion over 10 years; $5.4 billion a year is a lot of money, except in the context of the $2.5 trillion bill that we pay each year for health care. It represents one-fifth of 1 percent of the amount of money we spend each year on health care.

The Congressional Budget Office said something else. They said and as you lose accountability for what the doctors and hospitals are doing, more people will die — 4,800 a year, according to the Congressional Budget Office’s reference to this study.
(more…)

February 24, 2010

PIA Hails Removal of Medical Malpractice Insurers From Bill Restricting Insurance Antitrust Exemption

side note: This is actually a big deal. If the medical liability insurance industry had lost its anti-trust exemption, in all likelihood, malpractice premiums would have risen simply out of fear of the unknown. Sharing underwriting data is key to the medmal insurers ability to forecast losses.

The National Association of Professional Insurance Agents (PIA) is hailing the elimination of medical malpractice insurers from the draft of a bill restricting the limited federal insurance antitrust exemption under the McCarran-Ferguson Act.

According to the draft of the bill, to be called the Health Insurance Industry Fair Competition Act, posted on the House Rules Committee website as “text of bill to be introduced,” the scope of the bill has been narrowed to cover health insurers, but not medical malpractice insurers.

“The inclusion of medical malpractice insurance, a property/casualty product, was particularly inappropriate in that it did not relate directly to health insurance,” said PIA National Director of Federal Affairs Mike Becker. “A reduction in medical malpractice insurance rates is best achieved through separate legislation addressing tort reform.”
(more…)

February 19, 2010

Another view of the recent Illinois Supreme Court verdict on Medical Malpractice Insurance

side note: Here’s a good look at the potential impact — or lack thereof — by the Illinois Supreme Court decision on medical malpractice caps.

Although medical malpractice awards climbed in the years before Illinois put limits on them, opponents disagree on the impact of the recent Supreme Court’s ruling striking down the caps.

The average award for emotional harm in medical malpractice cases increased 437 percent in the seven years leading up to creation of the 2005 law capping non-economic damages, according to data from the Cook County Jury Verdict Reporter. Rates were highest in 2004, the year before award caps were enacted, with an average award of $4.8 million.

Physicians argue that high awards drive up insurance premiums and make health care more expensive.

“When the cap was reinstated in 2005, premiums for Chicago physicians stabilized and even began to shrink,” said J. James Rohack, president of the American Medical Association in a statement after the court ruling. Before caps on damages, premiums rose steadily 10 to 12 percent a year between 1997 and 2005, Rohack said.

The Medical Malpractice Act limited the amount victims could receive for emotional harm to $500,000 from doctors and $1 million from hospitals.The Illinois Supreme Court ruled the law unconstitutional earlier this month. This was the third time the court ruled against medical malpractice award caps.

Critics of award caps say the averages don’t tell the entire story.

“A single larger case can skew those numbers,” said Peter Flowers, president of the Illinois Trial Lawyers Association. “So looking at [the award amounts] as an average, isn’t really a clear assessment.”
(more…)

Older Posts »

Powered by WordPress