AMC/NOMA Members Doctors James Lane, John Bastulli, Kevin Geraci and Victor Bello, along with AMC/NOMA Executive VP/CEO Elayne Biddlestone, met with U.S. Senator George Voinovich and his aide Nick Gattozzi on September 29, 2003, regarding the medical liability crisis and its impact on Northeast Ohio physicians.
The Senator began the meeting by stating that he was not in agreement with the latest General Accounting Office (GAO) report titled “Medical Malpractice Insurance: Multiple Factors Have Contributed to Premium Rate Increases” and released on October 1, 2003.
In the report, the GAO acknowledges that severe premium rate increases of the last few years have greatly affected physicians, however, they do not believe immediate action should be taken to pass tort reform legislation. Senator Voinovich said it is very important that AMC/NOMA physicians respond to the data contained in this report.
AMC/NOMA leadership informed the Senator that the AMC/NOMA is in the process of doing a survey to demonstrate the magnitude of the problem in Northern Ohio – not only with medical liability coverage but how it affects access to care for patients. Another survey for physicians regarding economic trends is also in the works (see related story on page XX). The Senator is contemplating the next chapter on medical liability and acknowledged that there is some discussion about coming back with a bill dealing only with OB/GYNs and Neurosurgeons.
The physicians present noted that the specialty approach would be problematic for physicians. Insurers might then shift the expense to hospitals or other physicians. When a patient is admitted under one service, there are many other services and physicians that take care of that patient. Regardless, medical liability rates are still rising in other states, such as Indiana and California. While they have not seen the escalation in rates that we have in Ohio, covering just certain specialties in legislation will not help with that problem.
The Senator also acknowledged the “huge burden” HIPAA legislation is having on physicians. Several physicians mentioned that groups have spent close to $100,000 to become HIPAA compliant. Senator Voinovich indicated that they did a survey on HIPAA and the statistics showed that the benefits are far exceeded by the costs. He felt that HIPAA was a problem and it was one of the things that could be changed that has had an impact on medical costs.
Senator Voinovich also stated that the hospitals could do a lot better on the issue of medical errors. The AMC/NOMA physicians noted that hospitals want to do a good job and that the AMC/NOMA is a proponent of patient safety. The problem they will continue to have is that the more this type of information can become public, the less reporting there will be. The hospitals have to be sure that there will be no reprisals either internally or externally. Likewise, others may obtain the information. If the physician gets sued, everyone gets named and it causes stress and additional issues, regardless if the case has merit.
Senator Voinovich mentioned that he has also heard that there are physicians that are reluctant to treat infants because there is a “long tail” on that type of treatment. Some physicians are also reluctant to treat patients in nursing homes as well due to medical liability issues. He stated that they are pushing U.S. Senate Majority Leader Bill Frist M.D. (R-Tennessee) to get something out on this issue as soon as possible. AMC/NOMA offered any assistance he would need.
Another point of inclusion that concerned AMC/NOMA physicians was Medicare reimbursement. Several letters were sent to the Senator and his colleagues that discussed this issue.
Senator Voinovich indicated that he is talking about putting a group together to talk about the issue of health care and physician reimbursement. AMC/NOMA offered to supply a physician representatives to participate in this group.
AMC/NOMA encourages physicians to communicate directly with Ohio’s federal legislators and provide them with their own personal testimony. A link to their websites can be accessed through AMC/NOMA’s website at www.amcnoma.org
For the full text on the GAO report, visit http://www.gao.gov/atext/d04128t.txt
Medical Liability Coverage and Medical Students in the Physician’s Office – AMC/NOMA Receives Response
An article in the previous edition of Cleveland Physician told how AMC/NOMA was in discussion with a prominent medical liability insurer, GE Medical Protective, regarding the assumption that the supervision of medical students in a physician’s practice created an additional liability risk.
Due to the Academy’s efforts, GE Medical Protective clarified their underwriting position on the issue:
“GE Medical Protective does not believe physicians who choose to supervise medical students in their practice represent a higher liability risk. Thus, they will not see an increase in either their rates or a change in their coverage based solely on the fact that they supervise medical students in their practice.”
This is an example of how the Physician Advocacy
Committee can assist physicians on specific issues. We urge our members to send
in letters regarding issues such as these.
The committee’s charge is to “present and protect
the rights, responsibilities and interests of physicians in all modes of
medical practice, including those in independent practice and group practice, employed
physicians, academicians, hospital medical staff and others. This will include
physician self-governance, the credentialing process and significant
involvement in medical policy development, to include, but not limited to
patient and physician advocacy, reviews of professional liability insurance
industry actions and to report such information to the members of the board, as
well as collect information, when possible, on issues involving the legal
system in the region in relation to physicians. The committee will also
receive, review and attempt to resolve disputes or conflicts involving any
physician member of a medical staff and structured medical entity (AMC/NOMA
members only).”
The AMC/NOMA is the
physician advocacy group in Northeastern Ohio. Let us help you! Letters may be
sent to: Physician Advocacy Committee, AMC/NOMA, 6000 Rockside Woods Boulevard,
Cleveland, OH 44131-2352.
Ohio Senator Fingerhut Appears Before AMC/NOMA’s Board of Directors
In the September 9th
meeting of AMC/NOMA’s Board of Directors, Senator Eric Fingerhut (D-Shaker
Heights) reviewed several bills he has introduced that are awaiting committee
referral before the Ohio legislature – SB 111, 112, 113 and 114.
Senate Bill 111 recreates and
provide for the operation of the Joint Underwriting Association (JUA) relative
to the issuance of medical malpractice insurance, which was dissolved by the
Superintendent of Insurance in the early 1990s. The bill also establishes a
Stabilization Reserve Fund (SRF) for the Joint Underwriting Association.
Senate Bill 112 enacts
section 3937.51 of the Ohio Revised Code to establish a term of five years for
medical malpractice insurance policies and to limit premium increases during
that period.
Senate Bill 113 creates the
Medical Malpractice Insurance Review Commission and provides for the assessment
of insurance companies and health insuring corporations to cover the
Commission’s operating expenses.
Senate Bill 114 provides for
the formation of a nonprofit corporation, controlled by, and a membership
consisting exclusively of, physicians, designed to assist its members in
obtaining medical malpractice coverage.
Dr. Lane thanked Senator Fingerhut
for attending the meeting and asked the Senator why he believes this
legislation is needed and what he believes it would accomplish if passed. In
response, Senator Fingerhut provided detailed information about each bill.
Upon reviewing the pieces of
legislation, AMC/NOMA Board members were curious about how some of these
concepts would be funded. For example, where would the funding for the JUA come
from? Would it be funded through a surcharge on insurance premiums and
policies? Would money remaining from
the previous JUA fund be used? Was the plan to start with a temporary surcharge
and hope that this problem would resolve itself? Would there be a surcharge on
insurance companies as well?
The Senator indicated that he is
“wide open” to ideas and that he would have no problem with a surcharge on the
insurance companies doing business in the state.
Another concern raised by AMC/NOMA
was that putting stringent caps on insurance companies or the 5 percent
increase mandate on these companies could drive the insurance companies out of
the market and have an opposite effect since this would eliminate competition
in the state. This has been the effect in other states with a similar concept.
Senator Fingerhut stated that he
has not been an advocate for price controls. The root of what he is after here
is a need to return pricing to an actuarial soundness. The Senator also has a
problem with how the Ohio Department of Insurance (ODI) has applied its
authority to rules and regulations on prospective premiums.
The Senator stated that he
believes that there are many elements of tort reform pending that would make
the legal system fair to all parties. He has been open to medical screening
panels, specialized courts and arbitration. While all of these things warrant
discussion, he believes the structure of the way we pay attorneys on both sides
is problematic.
A question was raised as to
whether or not the senator had any ideas on how to attract insurance companies
to the state and bring them into the pipeline. The Senator stated that
competition for market share is still a problem, but he believes that establishing
a backup system, like JUA, would help things stabilize.
The AMC/NOMA noted
the need for predictability in the system and the need for additional
legislation that we did not get in Senate Bill 281. The Senator indicated that
he was open to ideas and hoped to continue the dialogue with AMC/NOMA