U.S. House again passes medical liability reform bill

New legislation would cap non-economic damages and give a larger piece of damage awards to patients and a smaller piece to attorneys.

The U.S. House of Representatives in late July once again passed a medical liability reform bill that would cap non-economic damages and limit contingency fees that plaintiffs’ attorneys may charge. The House has passed several medical liability reform bills, but nothing has yet been passed by the Senate.

This time the House voted 230-194, with 216 Republicans and 14 Democrats in favor. Nine Republicans voted against it. In its last session, the House passed four bills dealing with obstetric care, trauma and other specialties. However, none could get the 60 votes needed to move to a House-Senate conference committee. Whether such a measure can make it through the Senate this time remains in question.

The House legislation would cap punitive damages at $250,000 or double the total amount of economic damages, or the larger of the two. It would also establish a reasonable statute of limitations for filing lawsuits, expediting malpractice claims settlement.

The liability reform bill’s supporters say the caps would hold malpractice insurance premiums down, help keep doctors in their home states and ease increases in medical care costs. Opponents, including attorneys and consumer advocacy groups, say the law would deny malpractice victims fair compensation for damages.

“I think it was a vote we expected,” said Stuart L. Weinstein, MD, president of the American Association of Orthopaedic Surgeons (AAOS) and chair of the AAOS Medical Liability Reform Oversight Committee. He also serves as chairman of Doctors for Medical Liability Reform (DMLR), which represents over 230,000 physicians from 11 specialties and is the largest physicians’ group advocating federal medical liability reform.

Senate ‘hang-up’

“We’re hoping that after the congressional recess this summer the Senate will address the issue,” Weinstein told Orthopedics Today. “The Senate, once again, is the hang-up ... for us. As the DMLR group, our question is whether they are going to bring it up this year.”

Energized by a public education campaign it ran during the November 2004 congressional elections, the DMLR is preparing to launch another campaign to coincide with the 2006 senatorial races focusing on getting Senators and voters alike to support liability reform, Weinstein said.

“From the federal level, we’re currently organizing ourselves to help educate the public in the 2006 senatorial campaigns that will be unfolding,” he said.

State laws under siege

Overturned liability laws in some states underscore the need for a federal medical liability reform law, Weinstein said. In early July, the Wisconsin Supreme Court overturnd that state’s liability law, which provided caps on noneconomic damages. The American Medical Association had earlier classified Wisconsin as a “non-crisis state” because of the law.

In July, a Pennsylvania court overturned a law that restricted liability claims in civil lawsuits. The law had decreed that defendants who had less than 60% liability would not have to pay the entire award unless their actions were deemed intentional. The recent court ruling restored an earlier law, which stipulated that when two or more defendants are found negligent in a lawsuit, any of the parties can be made to pay the entire damage amount.

“Basically, the bottom line there is that this shows that state reform can always be overturned and that we need a federal solution to the issue,” Weinstein said.

Patient Safety Act

Also in late July, the U.S. House passed the Patient Safety and Quality Improvement Act. The Senate had passed the bill a week earlier, and President George W. Bush signed the bill into law.

The legislation sets up a national database of medical errors and requires the creation of databases containing patient safety information. Supporters believe the law might counteract the trend of patients blaming physicians for errors and filing lawsuits.

An Institute of Medicine study found that about 98,000 Americans die annually because of medical errors in hospitals.