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Pa. legislators approve malpractice-law overhaul
Ovetta Wiggins and Josh Goldstein INQUIRER STAFF WRITERS

The Pennsylvania General Assembly gave final approval yesterday to a medical malpractice package that will change how medical errors are reported and when patients can sue, and will lower how much doctors and hospitals pay for insurance.

The Senate approved the legislation with a 49-0 vote, and the House did in a 196-1 vote. Rep. Thomas Michlovic, a Democrat from Allegheny County, cast the only opposing vote, saying the measure didn't go far enough to protect patients.
The bill now heads to Gov. Schweiker, who is expected to sign it within the next week.

"This bill is a major, major step forward," House Majority Leader John Perzel (R., Phila.) said. "We believe it will relieve the pressure created by increasing malpractice insurance premiums. It protects every patient's right to sue. It takes new steps to better protect health-care professionals against outrageous lawsuits. It puts in place new patient-safety safeguards."

The bill includes legal changes to the malpractice system, provisions to improve patient safety, and the privatization of the state's Medical Professional Catastrophe Loss Fund (CAT Fund) in six years.

The tort-reform measures include requiring the payment of patients' future medical costs of more than $100,000 over time rather than in a lump sum and prohibiting patients from suing for damages that were paid by a health insurer.

Mandatory insurance coverage for doctors was reduced from $1.2 million to $1 million. The bill creates a patient safety authority to examine medical errors and recommend improvements. And it requires hospitals and doctors to notify patients in writing about serious medical mistakes.

Under the bill, patients who are injured because of a doctor's or hospital's mistake have seven years - from the time of injury - to file a claim. The limitation does not apply to children, who have until their 20th birthday to file a lawsuit.

"It's significant," said Drew Crompton, legal counsel for Robert Jubelirer (R., Blair), the lieutenant governor and Senate president pro tempore. "It's not as harsh as some other states, but it's a way of cutting costs."

The legislation puts the CAT Fund under the authority of the Department of Insurance, and phases out the fund over six years. It also takes $40 million a year for the next 10 years from the state's automobile Liability Catastrophe Loss Fund to lower doctors' insurance rates.

Legislative staffers said the overall package was expected to save doctors 10 percent to 20 percent on their malpractice premiums in the long term.

Hal Cohan, a family doctor who practices in Franconia, Montgomery County, said he hopes the bill will help. He has seen his premiums jump 70 percent in the last year.

"It has really kind of crippled us," Cohan said of the rate hike. "I'm cautiously optimistic that [the bill means] our carrier will [stay] in the state of Pennsylvania and give us a reasonable premium so we can continue to do our job."

The measure that passed yesterday was the result of a deal reached in the early-morning hours by the interest groups, House and Senate leaders, and the Schweiker administration.

"Without question, the medical liability reforms contained in this legislation will place Pennsylvania in the forefront in addressing what is clearly becoming a national crisis for physicians and their patients," Howard Richter, president of the Pennsylvania Medical Society, said.

"It is an important step forward, and we appreciate the efforts of the governor and the legislative leadership," said Andrew Wigglesworth, president of the Delaware Valley Healthcare Council, which represents local hospitals. "But no one should assume that this legislation is going to solve the problem. We need to continue to work on a whole range of activities to bring a liability system that is out of control under control."

Over the last year, doctors have complained that the state's lack of tort reform and its high malpractice premiums were driving some of their colleagues out of state and forcing others to retire early or scale back their practices.

The doctors say they are caught in a financial crunch between escalating costs and stagnant or declining reimbursements for medical care.

The votes yesterday end an intense yearlong lobbying campaign waged by the doctors, hospitals and trial lawyers.

In the last year, both groups, trying to align the support of patients and lawmakers, have taken out full-page newspaper ads and bought radio time and billboard space.

The doctors alleged that the availability of quality health care was at risk if medical malpractice reforms were not implemented. The trial lawyers, on the other hand, charged that the rights of injured patients were in jeopardy.

"While this bill begins to address patient safety, it falls short of the public disclosure needed to curb the rise of serious medical errors," said Cliff Rieders, president of the Pennsylvania Trial Lawyers Association. "Patients did not get what they deserved from this bill."

The votes also ended a game of hot potato in the General Assembly, where the bill has moved back and forth between the two chambers over the last two months.

In late January, the House approved a plan that largely gave doctors what they wanted, including limits on pain-and-suffering awards and provisions on where a lawsuit could be filed. But participants in the legislature and outside observers said that bill would be changed as a result of weeks of intense negotiations among all the interest groups under the auspices of Senate Majority Leader David J. "Chip" Brightbill (R., Lebanon).

Last month, the Senate passed a bill that was the result of those negotiations, and sent it to the House. The House then changed the bill again, causing the package to stall.

This version of the legislation resembles the Senate bill, with some relatively small changes that give judges guidelines on how to deal with large jury awards that providers challenged as excessive and that impose time limits on when suits could be filed.

Michlovic, the lone dissenter, said the bill should require disclosure of doctors with bad malpractice records.

"In the 24 years that I've been here, we've had three medical malpractice crisis in this state, one in the 1980s, the 1990s and 2000s," he said. "I will not be here for the next crisis, and I assure there will be one . . . because [the bill] doesn't address the sources of the problem, those who create [errors]."

Contact Ovetta Wiggins at 717-787-5934 or [email protected].

Key Elements of Pa. Malpractice Bill

Patient Safety

* Creates independent authority to analyze medical errors at hospitals and recommend changes.

* Requires notification of patients when serious medical mistakes occur.

* Increases the medical licensing board's authority to investigate and discipline negligent doctors.

Legal Changes

* Requires payment over time of patients' future medical expenses above $100,000.

* Precludes patients from recovering damages for medical expenses already paid by insurers.

* Requires judicial qualification of a medical expert before testimony.

* Requires community access to health care to be considered when a health-care provider challenges a jury award as excessive.

CAT Fund

* Reduces mandatory insurance coverage limits from $1.2 million to $1 million.

* Provides $40 million a year for a decade to reduce doctors' malpractice costs.

* Places the fund under the Department of Insurance and privatizes the fund after six years.

Copyright (c) 2002 The Philadelphia Inquirer

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