Less than zero: The effect on clinics of raising MICRA s $250,000 cap
|
|
- Janel Chloe Scott
- 8 years ago
- Views:
Transcription
1 Less than zero: The effect on clinics of raising MICRA s $250,000 cap By Jay Angoff This white paper addresses the effect on Community Health Centers of increasing California s $250,000 limit on compensation for pain and suffering in medical malpractice cases. Having regulated medical malpractice rates and analyzed the causes of malpractice insurance rate increases as Missouri s Insurance Commissioner during the 1990 s, I have a particular interest in this issue. In addition, as the first Director of the HHS Office implementing the Affordable Care Act s insurance reforms, as Senior Advisor to Secretary Sebelius and as an HHS Regional Director, I had the pleasure of visiting health centers throughout the nation. I saw first-hand the high-quality care they provide, and witnessed how so many people--about 20 million nationwide--depend on health centers. Health centers enjoy immunity from medical malpractice liability because of federal law, thereby insulating them from any effects changes to malpractice law might cause. This fact explains the sustained, very high profitability of the medical malpractice insurance industry in California, and why that profitability will continue if the MICRA cap is increased. History Health centers are community-based and patient-directed organizations that provide primary health care to the medically underserved. They receive funding pursuant to the Health Center Program established by sec. 330 of the Public Health Service Act, 42 U.S.C. 254b, which is administered by the Health Resources and Services Administration ("HRSA") at HHS. They make their services available to all, and charge based on ability to pay. Because they provide primary care, and thus do not perform highrisk procedures, they are inherently low-risk entities. Nevertheless, in the late 1980's malpractice insurers substantially raised the rates they charged health centers. Accordingly, in 1991 the U.S. Office of Management and Budget directed the HHS Office of Inspector General ("OIG") to report on health centers malpractice premiums and claims experience. In November 1991 the OIG issued a report concluding that "centers have paid high premiums relative to both the low number of claims filed against them and the small size of successful claims paid. HHS OIG, Medical Malpractice Insurance and the Community Health Centers, Nov. 1991, at 3. The OIG explained that,
2 Data from those centers that have been studied indicate that successful medical malpractice claims against them represent roughly 10 percent of the costs of premiums paid. By contrast, medical malpractice claims paid on behalf of all providers nationally represent 56 percent of premiums paid. The OIG report recommended various options for reducing health centers' malpractice insurance costs. One such option was to treat health centers as federal employees for purposes of the Federal Tort Claims Act ("FTCA"). Under the FTCA, individuals injured by the negligent acts of federal employees may seek and receive compensation from the federal government. 28 U.S.C. 1346(b), Treating health centers as federal employees for purposes of the FTCA would thus require individuals injured at health centers to sue the federal government rather than the provider; claims would be paid by the U.S. Treasury. Health centers would thereby no longer be liable for medical malpractice, and would have no need to buy medical malpractice insurance. In 1992 Congress adopted the OIG's recommendation by enacting the Federally Supported Health Centers Assistance Act ("FSHCAA"). The FSHCAA established a demonstration program for three years under which health centers were treated as federal employees under the FTCA. In 1995 Congress amended the FSHCAA to make permanent FTCA coverage of both health centers and health center officers, directors, employees and contractors. 42 U.S.C. 233(g)(1)(A). It thus immunized both centers and their personnel from medical malpractice liability, and eliminated the need for them to buy medical malpractice insurance. In 1996, Congress enacted the Health Insurance Portability and Accountability Act ( HIPAA ). HIPAA amended the FTCA so that it covered not only health centers and center personnel but also volunteers at free clinics. HIPAA sec. 194, PHSA sec. 224, codified at 42 U.S.C. 233(o). Like health centers, free clinics provide free care to the indigent, but unlike health centers they do not bill third-party payers nor do they meet other statutory criteria necessary to qualify as health centers. In 2004, Congress appropriated funds to protect free clinic volunteers. Finally, in 2010, the Affordable Care Act expanded FTCA coverage regarding free clinics so that it applied to free clinic officers, directors, employees and contractors as well as volunteers. Affordable Care Act sec , amending PHSA sec. 224(o)(1), codified at 42 U.S.C. 233(o)(1). Entities and Individuals Covered by the FTCA Entities Four different types of health centers are designated as eligible to receive federal funding under PHSA sec. 330 and to be treated as federal employees for purposes of the FTCA. Those four are Community Health Centers, Migrant Health Centers, Health Care for the Homeless Centers, and Public Housing Primary Care Centers. 42 U.S.C. 254b(a)(1); see also HRSA, FTCA FAQs, at In addition, Indian Health Service Clinics are subject to the FTCA. Although unlike health centers designated by PHSA sec. 330 they need not make their services available to all individuals, employees of the Indian Health Service are employees of the federal government and thus immune from medical malpractice liability under the FTCA.
3 Individuals The FTCA provides protection to both full and part-time employees including clinicians, administrators, directors, nurses, and other personnel; officers and governing board members; all full-time contractors--those working at least 32.5 hours a week; and part-time contractors in the fields of family practice, obstetrics and gynecology, general internal medicine, and general pediatrics. See HRSA, Federal Tort Claim Act Medical Malpractice Program, Sept. 15, 2008, at 5, accessed at In addition, the FTCA covers not only services rendered at community health center sites but also services rendered on behalf of the health center at alternative settings, including those in connection with hospital on-call arrangements, cross coverage arrangements, community outreach and interventions, emergencies due to natural disasters, health fairs, and clinical training. Id. Finally, the FTCA covers not only volunteers at free clinics but also free clinic officers, governing board members, employees, and contractors. Advantages of FTCA Coverage over Private Malpractice Insurance Coverage FTCA coverage provides health centers and free clinics with several advantages that private medical malpractice insurers often do not provide. For example: 1. Coverage under the FTCA is occurrence coverage, not claims-made coverage. Occurrence coverage covers the insured for any claim that arises during the policy year, even if the claim is made several years after the policy year. Claims-made coverage, in contrast, covers the insured only if the claim is made during the policy year. Occurrence coverage is therefore far broader than claims-made coverage. Traditionally, medical malpractice coverage has been occurrence coverage, but malpractice insurers now sell predominantly claims-made coverage, and charge insureds extra for so-called tail coverage for claims filed in the future that arose during the policy year. FTCA coverage, in contrast, has been and remains occurrence coverage. Thus, even if FTCA coverage of health centers were to be discontinued or a health center were to lose its federal funding, a provider would retain permanent protection for acts that occurred while he or she was working at the health center. See HRSA, Clinician s Handbook on the Federal Tort Claims Act, at 12, accessed at ftp://ftp.hrsa.gov/bphc/pdf/quality/2002clinicianhandbook.pdf. 2. Coverage under the FTCA is unlimited. Private medical malpractice coverage has limits--e.g., $1 million per occurrence and $3 million for all occurrences during a given year. FTCA coverage, in contrast, is unlimited. There is therefore no need for individuals protected by the FTCA to purchase excess coverage to cover them for unusually high claims. 3. FTCA coverage pays for all costs associated with litigation. Traditionally, private insurers have covered the costs of litigation in addition to covering claims up to a specified limit, such as $1 million/$3 million. In recent years, however, some insurers have begun selling so-called defense within limits policies, in which the limit say $1 million/$3 million applies to the total of claims payments plus legal fees. FTCA coverage, in contrast, covers both unlimited claims payments and unlimited legal expenses. Implications for health centers and free clinics of FTCA protection and its history Before health centers and free clinics gained FTCA protection, such centers and clinics had conflicting interests. On the one hand, they had a professional interest in maximizing the well-being of those they serve, including allowing those injured at health centers through no fault of their own to be adequately compensated for their pain and suffering. On the other hand, they had an economic interest in minimizing the amount they would have to pay to injured people or to malpractice insurance companies.
4 Today, however, they no longer have that economic interest, since they no longer have any obligation either to pay injured individuals or to pay malpractice insurance premiums. Therefore, increasing the MICRA cap would have no effect on health centers and free clinics or their ability to serve the underserved. In addition, before health centers and free clinics gained FTCA protection, they reasonably could have believed that the 56% of the premium dollar malpractice insurers paid out in claims, according to the 1991 OIG report, would rise in the future--and perhaps even rise to a level at which malpractice insurers became unprofitable. Today, however, we know that the opposite is the case. Malpractice insurers were very profitable at a 56% loss ratio--at that level 44 cents of the premium dollar, plus all investment income, is available for profit and expenses--but in recent years in California they have become even more profitable. Specifically, in each of the last ten years California malpractice insurers had loss ratios of no more than47%, and in each of the last eight years of no more than 38%--thus leaving at least 62 cents of the premium dollar, plus investment income, for expenses and profit. California Department of Insurance, Historical ( )Premium and Loss Charts by Line, at 13 (April 30, 2013). The high profitability of medical malpractice insurance in California is not directly relevant to health centers and free clinics due to their coverage by the FTCA. Nevertheless, that California private malpractice insurers are now paying out so little in claims may give comfort to centers and clinics, as well as to other parties, that malpractice insurers would still be highly profitable if the $250,000 limit on compensation for pain and suffering were increased. The Implications of the Affordable Care Act Finally, concern has been expressed that, given the necessity of implementing the Affordable Care Act in 2014, now is not the time to change California malpractice law. I would argue the opposite: that the benefits contained in the ACA for health care providers make this exactly the right time to bring MICRA into the 21 st century. (As you know, while the cost of everything has gone up in the last 38 years, the MICRA cap of $250,000 was not indexed for inflation. So while such a cap may have appeared reasonable in 1975, it clearly is not reasonable 38 years later, during which the cost of living has increased by more than 300%.) Here are just a few of the ACA s benefits for health care providers: 1. Additional funding for health centers. The ACA contains an additional $11 billion in funding for health centers, which can enable health centers to increase the amount they pay to doctors and other health care providers. 2. A $1.5 billion increase in National Health Service Corps funding. The National Health Service Corps makes grants and loans and offers loan forgiveness of up to $120,000 to doctors and other healthcare providers who practice in underserved areas for at least three years. 3. Raising the Medicaid rate for primary care doctors to the Medicare rate. Because health centers and free clinics provide primary care exclusively, this is a particular benefit to them, as well as to the doctors who provide services there. Raising primary care Medicaid rates to Medicare rates will increase Medicaid compensation to primary care doctors in California by 136%. Notably, the federal government pays the full cost of the increase.
5 4. Grants for or for the benefit of doctors. Doctors are either themselves eligible to participate in or can directly benefit from billions of dollars in grant funding under the Affordable Care Act, including Innovation Center grants, Prevention Fund grants, and Community Transformation grants. 5. Increased funding for advanced practice nurses and other non-physician health care providers. One of the ways to relieve the burden on doctors and to enable more people to obtain health care is to enable advanced practice nurses and other non-physician health care providers to provide all care that their training qualifies them to provide. The ACA authorizes both more funding for non-physician health practitioners and more funding for educating them. About the author: Jay Angoff is a former Acting Regional Director at the United States Department of Health & Human Services. He has been involved with the insurance industry and its regulation for more than 20 years, during which he has advocated on behalf of insurance consumers in state and federal courts, before state and federal administrative agencies, in Congress, and before the legislatures of more than 40 states. From January 1999 to December 1999, Mr. Angoff served as Director of the U.S. Health Care Financing Administration's private health insurance group, where he oversaw federal enforcement of recently enacted legislation governing the portability of health insurance coverage. Prior to that, Mr. Angoff served as the insurance commissioner of the State of Missouri. From 1991 to 1993, Mr. Angoff served as special assistant for health insurance policy to the Governor of New Jersey. Prior to that, he was Deputy Commissioner of the New Jersey insurance department.
Kansas Health Care Stabilization Fund General Information (As of July 1, 2014)
Kansas Health Care Stabilization Fund General Information (As of July 1, 2014) The HCSF Board of Governors The Health Care Stabilization Fund Board of Governors is a state agency governed by an eleven
More informationCost to the Government for Providing Medical Malpractice Coverage to Community and Migrant Health Centers (A-04-95-05018)
.. 19.1({,, *+ + - *. DEPARTMENT OF HEALTH& HUMAN SERVICES Off Ice of Inspector Genera! 5 * 3 +4 c * 2*,4,0 MAR2519% Memorandum Date. %A4.@7- June Gibbs Brown From (& Inspector General Subject Cost to
More informationDrug and Alcohol Testing of Doctors. Medical Negligence Lawsuits. Initiative Statute.
osition Official Title and Summary Prepared by the Attorney General Requires drug and alcohol testing of doctors and reporting of positive test to the California Medical Board. Requires Board to suspend
More informationDrug and Alcohol Testing of Doctors. Medical Negligence Lawsuits. Initiative Statute.
Proposition 46 Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits. Initiative Statute. Yes/No Statement A YES vote on this measure means: The cap on medical malpractice damages for such things
More informationTestimony Before: Senate Codes, Health & Insurance Committees. 10:00 a.m. Hearing Room B, Legislative Office Building Albany, NY
Testimony Before: Senate Codes, Health & Insurance Committees Tuesday, December 1, 2009 10:00 a.m. Hearing Room B, Legislative Office Building Albany, NY Presented By: Dr. William Doscher, MD, FACS Legislative
More informationFEDERAL TORT CLAIMS ACT Health Center Policy Manual
U.S. Department of Health and Human Services Health Resources and Services Administration FEDERAL TORT CLAIMS ACT Health Center Policy Manual (Supersedes PIN 2011-01) Updated 7/21/2014 1 Table of Contents
More informationKey Provisions Related to Nursing Nursing Workforce Development
Key Provisions Related to Nursing The newly released House bill, the Affordable Health Care for America Act (HR 3962), clearly represents a movement toward much-needed, comprehensive and meaningful reform
More informationQUESTION NO. 3. Amendment to Titles 1 and 3 of the Nevada Revised Statutes. CONDENSATION (ballot question)
QUESTION NO. 3 Amendment to Titles 1 and 3 of the Nevada Revised Statutes CONDENSATION (ballot question) Shall Title 1 of the Nevada Revised Statutes governing attorneys, and Title 3 of the Nevada Revised
More informationBACKGROUND. August 28, 2013. Hon. Kamala D. Harris Attorney General 1300 I Street, 17 th Floor Sacramento, California 95814. Initiative Coordinator
August 28, 2013 Hon. Kamala D. Harris Attorney General 1300 I Street, 17 th Floor Sacramento, California 95814 Attention: Ms. Ashley Johansson Initiative Coordinator Dear Attorney General Harris: Pursuant
More informationSection 304 - What it Means to the United States Government
Guidance for the Healthcare Community Concerning Section 304 of the Homeland Security Act Manufacturers of smallpox vaccine and those healthcare entities under whose auspices the vaccine would be administered
More informationSUPPLEMENTAL NOTE ON HOUSE BILL NO. 2516
SESSION OF 2014 SUPPLEMENTAL NOTE ON HOUSE BILL NO. 2516 As Amended by House Committee on Insurance Brief* HB 2516 would amend provisions relating to the operation of mutual insurance companies organized
More informationThis briefing paper summarizes the measures the Montana Legislature has put into place to improve the state's medical liability climate.
SRJ 35: Study of Health Care Medical Malpractice: Montana's Approach to Limiting Liability by Sue O'Connell, Research Analyst Prepared for the Children, Families, Health, and Human Services Interim Committee
More informationAmerican Indian Health Commission for Washington State Improving Indian Health through Tribal-State Collaboration
American Indian Health Commission for Washington State Improving Indian Health through Tribal-State Collaboration Washington Insurance Issuer Requirements for American Indian/Alaska Native Enrollees and
More informationHealth Reform and the AAP: What the New Law Means for Children and Pediatricians
Health Reform and the AAP: What the New Law Means for Children and Pediatricians Throughout the health reform process, the American Academy of Pediatrics has focused on three fundamental priorities for
More informationSummary of the Major Provisions in the Patient Protection and Affordable Health Care Act
Summary of the Major Provisions in the Patient Protection and Affordable Care Act Updated 10/22/10 On March 23, 2010, President Barack Obama signed into law comprehensive health care reform legislation,
More informationANNUAL REPORT Per SCR 111 of 2007
ANNUAL REPORT Per SCR 111 of 2007 BY LOUISIANA PATIENT S COMPENSATION FUND October 1, 2008 A BRIEF HISTORY OF THE LOUISIANA PATIENT S COMPENSATION FUND In the early 1970 s, a problem of crisis proportions
More informationAppendix 1: State Licensure and Liability Policies for Volunteer Physicians; American Medical Association Publication, 2007
Appendix 1: State Licensure and Liability Policies for Volunteer Physicians; American Medical Association Publication, 2007 State Alabama Volunteer/Limited License Offered No provisions for volunteer or
More informationCredentialing, Privileging, and FTCA: Federal Tort Claims Act and Health Centers
Credentialing, Privileging, and FTCA: Federal Tort Claims Act and Health Centers Pennsylvania Primary Care Association October 21, 2010 Felicia B. Eshragh, JD, MPH Christopher Gibbs, JD, MPH Department
More informationMedical professional liability (MPL) insurance costs at a crossroads
Bracing for change Medical professional liability (MPL) insurance costs at a crossroads John F. Gibson Principal Dorothy A. Woodrum Director PwC Actuarial and Insurance Management Solutions (AIMS) Agenda
More informationAN OVERVIEW OF THE WISCONSIN HEALTH CARE LIABILITY AND PATIENTS COMPENSATION ACT
AN OVERVIEW OF THE WISCONSIN HEALTH CARE LIABILITY AND PATIENTS COMPENSATION ACT A REPORT TO THE SJR 32 SUBCOMMITTEE ON MEDICAL LIABILITY INSURANCE Prepared by David D. Bohyer, Research Director March
More informationThe Facts About Medical Malpractice in Pennsylvania Congress Watch March 2004
The Facts About Medical Malpractice in Pennsylvania Congress Watch March 2004 Public Citizen s Congress Watch i Medical Malpractice in Pennsylvania Executive Summary Section I: Lawsuits Are Not Responsible
More informationSenate Bill No. 2 CHAPTER 673
Senate Bill No. 2 CHAPTER 673 An act to amend Section 6254 of the Government Code, to add Article 3.11 (commencing with Section 1357.20) to Chapter 2.2 of Division 2 of the Health and Safety Code, to add
More informationAn Internist s Practical Guide to Understanding Health System Reform
An Internist s Practical Guide to Understanding Health System Reform Prepared by: ACP s Division of Governmental Affairs and Public Policy Updated October 2013 How to cite this guide: American College
More informationNACHC ANALYSIS: Federal Tort Claims Act Coverage: Reducing Exposure for Common Gap Areas. September 2009
NACHC ANALYSIS: Federal Tort Claims Act Coverage: Reducing Exposure for Common Gap Areas September 2009 Prepared by: Marcie Zakheim, Esq. Feldesman Tucker Leifer Fidell LLP 2001 L Street, NW Second Floor
More informationBracing for change Medical professional liability (MPL) insurance costs at a crossroads
February 2011 Bracing for change Medical professional liability (MPL) insurance costs at a crossroads At a glance The effects of the healthcare reform law, changing market conditions, emerging societal
More informationCommunity Health Centers: Workforce and Access Issues
Community Health Centers: Workforce and Access Issues Local Perspective Family Health Centers, Inc. Louisville, KY Federally Qualified Health Center 20 FQHC grantees in Kentucky (4 urban) 1200 FQHCs Nationally
More informationCommunity Clinics and Health Centers under the Patient Protection and Affordable Care Act
Community Clinics and Health Centers under the Patient Protection and Affordable Care Act Background On March 23, 2010, President Barack Obama signed into law a comprehensive health care reform bill, the
More informationL E G I S L A T I V E A N A L Y S T S O F F I C E. Assembly Judiciary Committee Hon. Bob Wieckowski, Chair
September 29, 2014 Proposition 46: Drug and Alcohol Testing of Doctors. Medical Negligence Lawsuits. L E G I S L A T I V E A N A L Y S T S O F F I C E Presented to: Assembly Health Committee Hon. Richard
More informationPublic Policy Position
ISSUE In line with the overall tort system, the purpose of medical malpractice liability is to compensate patients who suffer an injury as a result of medical negligence. However, an effective tort system
More informationHOUSE OF REPRESENTATIVES 2252 TWENTY-EIGHTH LEGISLATURE, 2016 H.D. 1 STATE OF HAWAII A BILL FOR AN ACT
HOUSE OF REPRESENTATIVES 2252 TWENTY-EIGHTH LEGISLATURE, 2016 H.D. 1 STATE OF HAWAII A BILL FOR AN ACT RELATING TO DISCHARGE PLANNING. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII: 1 SECTION
More informationA Handbook on California s Medical Injury Compensation Reform Act
A Handbook on California s Medical Injury Compensation Reform Act MICRA MEDICAL INJURY COMPENSATION REFORM ACT MICRA California s landmark Medical Injury Compensation Reform Act has successfully relieved
More informationGUIDE TO HEALTH CARE REFORM S TAX PENALTIES
The GUIDE TO HEALTH CARE REFORM S TAX PENALTIES Calculate Your Health Insurance Tax Penalty 2 Introduction The Affordable Care Act (ACA) requires certain employers and employees to purchase health insurance
More informationWhile health care reform has its foundation and framework at
CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Policy Brief June 2010 The Patient Protection and Affordable Care Act at the State and Local Level While health care reform has its foundation and framework
More informationPension & Health Benefits Committee California Public Employees Retirement System
California Public Employees Retirement System Agenda Item 9 ITEM NAME: Proposition 46 Drug and Alcohol Testing of Doctors and Medical Negligence Lawsuits PROGRAM: ITEM TYPE: Legislation State Initiative
More informationTHE NUTS AND BOLTS OF FTCA JUNE 6, 2013
AMERICA S HEALTH CENTERS THE NUTS AND BOLTS OF FTCA JUNE 6, 2013 Dr. Keith Horwood, Salt Lake City, Utah Dr. Ron Yee, Parlier, California Disclaimer The presentation and materials for this Interactive
More informationANNUAL STUDY OF MEDICAL MALPRACTICE INSURANCE MARKET IN ARKANSAS
A REPORT TO THE LEGISLATIVE COUNCIL AND THE SENATE AND HOUSE COMMITTEES ON INSURANCE AND COMMERCE OF THE ARKANSAS GENERAL ASSEMBLY (AS REQUIRED BY 1007 OF 2003) ANNUAL STUDY OF MEDICAL MALPRACTICE INSURANCE
More informationHOUSE BILL 924. P1, J1, J2 1lr1413 A BILL ENTITLED. Commission on State Administered Medical Malpractice Liability Insurance
HOUSE BILL P, J, J lr By: Delegate Mizeur Introduced and read first time: February, Assigned to: Economic Matters A BILL ENTITLED AN ACT concerning Commission on State Administered Medical Malpractice
More informationMedical Professional Liability Update - State Legislatures and Lung Cancer Prevention
Medical Professional Liability Update: Anne E. Bryant Senior Director of Government Relations Physicians Insurance A Mutual Company Anne@phyins.com 206-343-7300 Medical Professional Liability Update Federal
More informationGeorgia Board for Physician Workforce
Board for Physician Workforce Spotlight on National Tort Reform & Reform in the Surrounding States August 2010 Tort reform continues to be a highly debated issue at both the state and national level. In
More informationReview of the Affordable Health Choices Act (Kennedy Bill)
Review of the Affordable Health Choices Act (Kennedy Bill) Below is a review of those measures contained in the Affordable Health Choices Act introduced by Senator Edward Kennedy (D-MA) via the Senate
More informationTHE GOOD SAMARITAN ACT AND PROTECTION FROM LIABILITY
CHAPTER 7 THE GOOD SAMARITAN ACT AND PROTECTION FROM LIABILITY by George F. Indest III, JD, MPA, LL.M SCOPE This chapter discusses the FLorida Good Samaritan Law and other laws which protect physicians
More informationAdvocate Magazine March 2011. Why medical malpractice still matters.
Advocate Magazine March 2011 Why medical malpractice still matters. Despite MICRA limitations, medical-negligence claims still have a crucial role in society BY BRUCE G. FAGEL We all know the statistics
More informationRe: CMS-9964-P: Proposed Rule, Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014
December 31, 2012 Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-9964-P P.O. Box 8016 Baltimore, MD 21244-8016 Re: CMS-9964-P: Proposed Rule, Patient
More informationPossible Opportunities for Collaboration in Health Care Reform
MEDICARE EXTENDERS Part B Payments to Indian Hospitals and Clinics. (Sec. 2902) Spends $200 million over 10 years. Section 630 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003
More informationShould New Mexico increase the medical malpractice cap?
Should New Mexico increase the medical malpractice cap? 1 A REVIEW OF RECENT LEGISLATION LIKELY EFFECTS OF A CAP INCREASE PRESENTATION TO THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE NOVEMBER 3,
More informationMedicare Costs and People with Supplemental Coverage
Medicare Costs and People with Supplemental Coverage NAIC Senior Issues Task Force Medigap PPACA (B) Subgroup March 23, 2011 California Health Advocates and its members have extensive experience with Medicare
More information*SB0168* S.B. 168 1 CHARITY CARE AMENDMENTS. LEGISLATIVE GENERAL COUNSEL Approved for Filing: C.J. Dupont 01-30-14 5:56 AM
LEGISLATIVE GENERAL COUNSEL Approved for Filing: C.J. Dupont 01-30-14 5:56 AM S.B. 168 1 CHARITY CARE AMENDMENTS 2 2014 GENERAL SESSION 3 STATE OF UTAH 4 Chief Sponsor: Allen M. Christensen 5 House Sponsor:
More information58-13-1. Title. This chapter is known as the "Health Care Providers Immunity from Liability Act."
58-13-1. Title. This chapter is known as the "Health Care Providers Immunity from Liability Act." Enacted by Chapter 253, 1996 General Session 58-13-2. Emergency care rendered by licensee. (1) A person
More informationProposed Amendments: N.J.A.C. 11:4-23A.2, 23A.6 and 23A.12. Authorized By: Holly C. Bakke, Commissioner, Department of Banking and Insurance
INSURANCE DEPARTMENT OF BANKING AND INSURANCE DIVISION OF INSURANCE Medicare Supplement--Under 50 Coverage Proposed Amendments: N.J.A.C. 11:4-23A.2, 23A.6 and 23A.12 Authorized By: Holly C. Bakke, Commissioner,
More informationThe New and Temporary Federal High-Risk Insurance Pool
The New and Temporary Federal High-Risk Insurance Pool By Craig A. Conway, J.D., LL.M. (Health Law) caconway@central.uh.edu The Patient Protection and Affordable Care Act (PPACA), 1 includes several measures
More informationCHAPTER 7 NURSING LIABILITY INSURANCE
CHAPTER 7 NURSING LIABILITY INSURANCE We have all read many articles on and heard seminar speakers advocate why nurses should not buy professional liability insurance. However, in our opinion, there are
More informationProfessional Liability Insurance Issues for CRNAs
Professional Liability Insurance Issues for CRNAs Louise E. Hershkowitz, CRNA, MSHA Pennsylvania Association of Nurse Anesthetists Hershey, Pennsylvania April 4, 2004 What is It? A Contract for Service
More informationAbout Mcare. (ii) Pay expenses of the fund incurred during the preceding claims period.
The Medical Care Availability and Reduction of Error Fund ( Mcare ) was created by Act 13 of 2002 ( Act 13 ), and signed into law on March 20, 2002. Mcare is the successor to the Medical Professional Liability
More informationHealth Insurance Exchange Study
Health Insurance Exchange Study Minnesota Department of Health February, 2008 Division of Health Policy Health Economics Program PO Box 64882 St. Paul, MN 55164-0882 (651) 201-3550 www.health.state.mn.us
More informationLegislative Council, State of Michigan Courtesy of www.legislature.mi.gov
PUBLIC HEALTH CODE (EXCERPT) Act 368 of 1978 PART 27 MICHIGAN ESSENTIAL HEALTH PROVIDER RECRUITMENT STRATEGY 333.2701 Definitions. Sec. 2701. As used in this part: (a) "Board certified" means certified
More informationFAQ New Health Insurance Law
FAQ New Health Insurance Law (Enacted on March 21, signed into law on March 23, and amended on March 25) On March 23, 2010 President Barack Obama signed the Patient Protection & Affordable Care Act (H.R.
More informationFederal Tort Claims Act (FTCA) Free Clinics Program Overview
Federal Tort Claims Act (FTCA) Free Clinics Program Overview April Fields Mike Chellis Department of Health and Human Services Health Resources and Services Administration Bureau of Primary Health Care
More informationIN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF WISCONSIN
IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF WISCONSIN ASSOCIATION OF AMERICAN PHYSICIANS & SURGEONS, INC., AND ROBERT T. MCQUEENEY, M.D., v. Plaintiffs, DANIEL I. WERFEL, ACTING COMMISSIONER
More informationKansas Health Care Stabilization Fund
Kansas Health Care Stabilization Fund Website http://hcsf.kansas.gov 300 S.W. 8 th Avenue, Second Floor E-mail hcsf@hcsf.org Topeka, Kansas 66603-3912 Fax: 785-291-3550 Phone 785-291-3777 Bulletin 2014-5
More informationAffordable Care Act Opportunities for the Aging Network
Affordable Care Act Opportunities for the Aging Network The Affordable Care Act (ACA) offers many opportunities for the Aging Network to be full partners in health system reform. These include demonstration
More informationSubject: Federal Tort Claims Act: Information Related to Implications of Extending Coverage to Volunteers at HRSA-Funded Health Centers
United States Government Accountability Office Washington, DC 20548 June 24, 2009 Congressional Committees Subject: Federal Tort Claims Act: Information Related to Implications of Extending Coverage to
More informationThe Income Tax Effects of Health Care Reform on Small Businesses and Real Estate Investors
The Income Tax Effects of Health Care Reform on Small Businesses and Real Estate Investors BY J. RUSSELL HARDIN, PH.D. INTRODUCTION IF REAL ESTATE INVESTORS AND SMALL BUSINESS OWNERS intend to maximize
More informationHealth Center Emergency Preparedness Guide
Legal & Liability Issues IN HEALTH CENTER EMERGENCY RESPONSE How This Guide Can Help Your Health Center: Liability is a complicated and fluid issue. This report serves as a snapshot of liability issues
More informationSome individuals are dual eligible meaning they qualify for both Medicaid and Medicare. In
Understanding Dual Eligibility The Interplay between Medicare and Medicaid Jason D. Lazarus, Esq. Introduction Some individuals are dual eligible meaning they qualify for both Medicaid and Medicare. In
More informationStrengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011.
Implementation Timeline Reflecting the Affordable Care Act 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access
More informationLEGISLA Alaska State Legislature
LEGISLA ATIVE RESEARCH SERVICES Alaska State Legislature Division of Legal and Research Services State Capitol, Juneau, AK 99801 (907) 465 3991 phone (907) 465 3908 fax research@legis.state.ak.us TO: FROM:
More information2015 IADC Mid-Year Meeting. Marco Island, Florida. Medical Liability and Health Law Committee Meeting
2015 IADC Mid-Year Meeting Marco Island, Florida Medical Liability and Health Law Committee Meeting Constitutional Challenges to Non-Economic Damages Caps The Florida Experience Jeptha F. Barbour, Esq.
More informationDo good, but do it right: Wyoming s Medical Volunteer Immunity Law Law s specific exceptions require Doctors to jump through some hoops
Do good, but do it right: Wyoming s Medical Volunteer Immunity Law Law s specific exceptions require Doctors to jump through some hoops By Nick Healey Dray, Dyekman, Reed & Healey, P.C. Wyoming physicians
More informationOCT 1 1 2005. Betty James Duke Administrator Health Resources and Services Administration
/. ""'CE DEPARTMENT OF HEALTH &. HUMAN SERVICES Office of Inspector General.("-"'''.0 Washington, D. C. 20201 OCT 1 1 2005 TO: Betty James Duke Administrator Health Resources and Services Administration
More informationQ. My company already offers employee health coverage, how does the law impact me?
Frequently Asked Questions Q. Will my business be required to provide employee health insurance under the health care law? A. The law does not mandate employers provide employees health care coverage.
More informationH.R. 5 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2003
CONGRESSIONAL BUDGET OFFICE COST ESTIMATE March 10, 2003 H.R. 5 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2003 As ordered reported by the House Committee on Energy and Commerce
More informationMedical Liability Task Force
Medical Liability Task Force Report and Recommendations Oregon Health Policy Board November 9, 2010 1 The Board s Charge to the Task Force Investigate the current medical liability system Suggest opportunities
More informationWhat s News in Tax Analysis That Matters from Washington National Tax
What s News in Tax Analysis That Matters from Washington National Tax The Impact of the Affordable Care Act on International Assignees and Their Health Care Plans Employers and individuals in the United
More informationSENATE BILL No. 358. Introduced by Senator Ducheny. February 25, 2009
SENATE BILL No. Introduced by Senator Ducheny February, 00 An act to amend Section 00 of, and to add Article 0 (commencing with Section 0) to Chapter of Part of Division of Title of, the Corporations Code,
More informationPART III MEDICAID LIEN RECOVERY. 1) From the estate of the Medicaid recipient.
PART III MEDICAID LIEN RECOVERY 1. Basics: 1) For Medicaid benefits that are correctly paid, there are two major instances in which Medicaid may seek to impose and recover liens: 1) From the estate of
More informationHolly C. Bakke, Commissioner, Department of Banking and Insurance. Authority: N.J.S.A.17:30D-17(a) and (b) and P.L. 2004 c. 17
INSURANCE DEPARTMENT OF BANKING AND INSURANCE DIVISION OF INSURANCE Medical Malpractice Reporting Requirements Proposed Amendments: N.J.A.C. 11:1-7.1 and 7.3 Authorized By: Holly C. Bakke, Commissioner,
More informationSUPPLEMENTAL NOTE ON SUBSTITUTE FOR SENATE BILL NO. 11
Corrected SESSION OF 2007 SUPPLEMENTAL NOTE ON SUBSTITUTE FOR SENATE BILL NO. 11 As Amended by House Committee of the W hole Brief* Sub. for SB 11, as amended by the House Committee of the Whole, would
More informationADVANCE DIRECTIVE VOLUME 19 SPRING 2010 PAGES 306-315. The Effect of Medical Malpractice. Jonathan Thomas *
ANNALS OF HEALTH LAW ADVANCE DIRECTIVE VOLUME 19 SPRING 2010 PAGES 306-315 The Effect of Medical Malpractice Jonathan Thomas * I. INTRODUCTION: WHAT IS MEDICAL MALPRACTICE Every year, medical malpractice
More informationHow To Raise The Medical Liability Cap In California
PROPOSITION 46: MEDICAL MALPRACTICE LAWSUITS CAP AND DRUG TESTING OF DOCTORS INITIATIVE September 2014 SDCTA Position: OPPOSE Rationale for Position: Raising the medical malpractice lawsuits cap will drive
More informationQuestions and Answers About Prop. 46 A costly threat to people s personal privacy Californians can t afford.
Questions and Answers About Prop. 46 A costly threat to people s personal privacy Californians can t afford. What will Prop. 46 do? Prop 46 does three things: Quadruples the limit on medical malpractice
More informationNEW JERSEY AUTO INSURANCE BUYER S GUIDE
NEW JERSEY AUTO INSURANCE BUYER S GUIDE AD9460ARR-0704 American Bankers Insurance Company of Florida American Bankers Insurance Company of Florida 11222 Quail Roost Drive, Miami, FL 33157-6596 NEW JERSEY
More informationPatient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms
Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms Provision Notes Standards Development Applicability Effective Date PPACA Statutory Annual and Lifetime Limits
More informationNEW JERSEY AUTO INSURANCE BUYER S GUIDE. Chris Christie Governor. Kim Guadagno Lt. Governor. Commissioner
NEW JERSEY AUTO INSURANCE BUYER S GUIDE Chris Christie Governor Kim Guadagno Lt. Governor Commissioner WHERE DO I START?... 1 UNDERSTANDING YOUR POLICY... 2-6 Types of Coverages Standard and Basic Policies
More informationArizona State Senate Issue Paper June 22, 2010 MEDICAL MALPRACTICE. Statute of Limitations. Note to Reader: INTRODUCTION
Arizona State Senate Issue Paper June 22, 2010 Note to Reader: The Senate Research Staff provides nonpartisan, objective legislative research, policy analysis and related assistance to the members of the
More informationCOBRA AND OTHER HEALTH CARE ISSUES
COBRA AND OTHER HEALTH CARE ISSUES By Debbie Dees Phelps Dunbar LLP 111 East Capitol Street, Suite 600 Post Office Box 23066 Jackson, Mississippi 39225-3066 Telephone: (601) 360-9334 Facsimile: (601) 360-9777
More informationAB 2458: Increasing Primary Care Practitioners
AB 2458: Increasing Primary Care Practitioners Summary: Assembly Bill 2458 establishes the Graduate Medical Education Fund to finance additional positions at residency programs in California hospitals
More informationThe recently enacted Health Information Technology for Economic
Investments in Health Information Technology Driven by HITECH Act Marcy Wilder, Donna A. Boswell, and BarBara Bennett The authors review provisions of the new stimulus package that authorize billions of
More informationWorker's Compensation Insurance in Wisconsin THE SYSTEM, THE BENEFITS, THE COSTS A REFERENCE GUIDE FOR EMPLOYERS
Worker's Compensation Insurance in Wisconsin THE SYSTEM, THE BENEFITS, THE COSTS A REFERENCE GUIDE FOR EMPLOYERS This guide is intended to provide a general, non-technical explanation to help employers
More informationCOMPARISON OF KEY PROVISIONS House and Senate Comprehensive Mental Health Reform Legislation
COMPARISON OF KEY PROVISIONS House and Senate Comprehensive Mental Health Reform Legislation Note: A full title-by-title summary of H.R. 2646, the Helping Families in Mental Health Crisis Act of 2015 (Murphy/Johnson)
More informationHealth Insurance and Women
Health Insurance and Women Q: What is health insurance? A: Health insurance is a formal agreement to provide and/or pay for medical care. The health insurance policy describes what medical services are
More informationSummary of Liability and Workers Compensation Protections for Massachusetts Health Care Volunteers in Disaster Response
Definitions Summary of Liability and Workers Compensation Protections for Massachusetts Health Care Volunteers in Disaster Response Disclaimer: This information is only a brief outline of liability and
More informationHow To Get A Workers Compensation Rate Decrease In Florida
Florida Workers Compensation Insurance Rates Decrease By 5.2% in 2015, Down by More than 57% Since the 2003 Reforms A. Introduction. Rafael Gonzalez Vice President of Strategic Solutions Helios Tampa,
More informationIt goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform.
WHAT IS HEALTHCARE REFORM? Healthcare Reform (HCR) is a law passed by Congress that provides many different requirements. A very important aspect of the law is that it is designed to provide individuals
More informationKansas Legislator Briefing Book 2016
K a n s a s L e g i s l a t i v e R e s e a r c h D e p a r t m e n t Kansas Legislator Briefing Book 2016 L-1 Creation of Operator Registration Act and Changes in Adult Care Home Licensure Act L-2 Health
More informationHEALTH REFORM and VACCINES: Review of Federal Legislation
HEALTH REFORM and VACCINES: Review of Federal Legislation The Patient Protection and Affordable Care Act (PPACA) And The Health Care and Education Reconciliation Act Alexandra Stewart June 2, 2012 1 Presentation
More informationEmployer s Guide To Health Care Reform
Employer s Guide To Health Care Reform A nonprofit independent licensee of the Blue Cross Blue Shield Association National strength. Local focus. Individual care. SM As part of our commitment to being
More informationMEDIATION AND ARBITRATION OF MEDICAL MALPRACTICE DISPUTES: TIME FOR A POSITIVE CHANGE
MEDIATION AND ARBITRATION OF MEDICAL MALPRACTICE DISPUTES: TIME FOR A POSITIVE CHANGE Prepared by James A. Christopherson, Esq. Dingeman, Dancer & Christopherson, PLC 100 Park Street Traverse City, MI
More informationMaryland Insurance Administration s 2005 Report on the Availability and Affordability of Health Care Medical Professional Liability Insurance in
Maryland Insurance Administration s 2005 Report on the Availability and Affordability of Health Care Medical Professional Liability Insurance in Maryland November, 2005 Maryland Insurance Administration's
More informationSECTION 1. Chapter 671, Hawaii Revised Statutes, is. amended by adding five new sections to be appropriately
A BILL FOR AN ACT NO. \32S RELATING TO TORTS. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII: SECTION 1. Chapter 671, Hawaii Revised Statutes, is amended by adding five new sections to be appropriately
More informationLiability Set Asides Why There is a Need for Codification
Liability Set Asides Why There is a Need for Codification Jason D. Lazarus, Esq. For many years personal injury cases have been resolved without consideration of Medicare s secondary payer status even
More information