You asked for summaries of medical malpractice bills that were reported out of committee this session. You also asked whether California or Florida require doctors to have medical malpractice insurance as a condition of practicing medicine.

Medical Malpractice Bills

The legislature reported out six medical malpractice bills this session. Following is a listing of each by bill and file number, title, committee of origin, and status.

Table 1: 2004 Medical Malpractice Bills

We have enclosed a detailed summary of each of these bills. Five of the bills (sHB 60, SB 141, sSB 356, sSB 394, and sHB 5669) are very similar. Each one makes numerous changes to the (1) the law dealing with civil litigation; (2) insurance regulation and oversight; and (3) the regulation, oversight, and disciplining of doctors. The changes in number two and three are in most respects identical, except sHB 5669 has unique provision that establishes a patient safety ombudsman within the Department of Public Health to improve patient safety and reduce medical errors.

The provisions dealing with civil litigation for the most part deal with similar areas. Some of these bills require those who file malpractice cases to first submit their claim to a medical malpractice screening panel before they can pursue their case in court (sSB 60, sSB 356, and sSB 394). Two of the bills eliminated the screening panel and instead mandate mediation (SB 141 and sHB 5669) and instead require that the claim be submitted to mediation before proceeding through the litigation process.

Three of the bills expand the current malpractice screening panel from three to four members by adding a judge trial referee (sSB 60, sSB 356, and sSB 394). Two these bills (sSB 60 and sSB 394) retain the requirement that the panel’s conclusions are admissible in a medical malpractice lawsuit only if the findings are unanimous. One bill (sSB 356) retains the three-member panel and permits admissibility of findings by a majority of the panel members.

Each one reduces the amount of interest the defendant must pay under the offer of judgment law. But they do so in different ways.

Each one addresses the contingency fee that attorneys may charge. One of the bills mandates that the current contingency fee schedule be complied with by outlawing waivers (SB 141). Four of the bills allow waivers only with court approval (sSB 60, sSB 356, sSB 394, and sHB 5669).

One of the bills establishes a task force to examine the feasibility of developing alternatives to the current litigation system for medical malpractice cases (SB 141).

One of the bills (sSB 61) establishes two funds to deal with the malpractice issues. One fund (called a Healthy Connecticut Fund) reimburses any parties of a medical malpractice settlement or judgment that represents the deductible portion of the defendant’s malpractice insurance policy. The other fund pays 50% of the portion of each malpractice settlement or judgment of between (1) $ 750,000 and $ 1,750,000 for each individual provider and (2) $ 1,500,000 and $ 2,500,000 for a hospital.

It also allows health care providers to deduct from their Connecticut adjusted gross income for state income tax purposes any amount they paid for premiums on a medical malpractice insurance policy.

sSB 394 also contains a fund to pay deductibles on malpractice insurance policies.

sHB also allows doctors to deduct any amount paid for malpractice insurance from their Connecticut adjusted gross income. It also provides money for a loan-forgiving program for people to complete medical training in obstetrics or neurosurgery at a medical school in Connecticut.

California and Florida

According to the American Medical Association (AMA), California does not require physicians to carry a minimum amount of medical malpractice insurance as a condition of practicing medicine.

Although Florida does not require malpractice insurance as a condition of practicing medicine, it generally requires some form of financial responsibility. This can take the form of malpractice insurance, an escrow account, or an irrevocable letter of credit. Also, the law exempts doctors from this requirement under certain circumstances.

Under federal law, physicians with hospital privileges must maintain either an escrow account consisting of cash or assets of not less than $ 250,000, liability insurance coverage of not less than $ 250,000 per claim or $ 750,000 in the annual aggregate, or obtain and maintain an unexpired, irrevocable letter of credit in an amount not less than $ 250,000 per claim or $ 750,000 in the aggregate. Physicians can also self-insure if they will pay $ 250,000 of any award within 60 days.

Physicians who do not have hospital privileges must have either, an escrow account consisting of cash or assets of not less than $ 100,000, liability insurance coverage of not less than $ 100,000 per claim or $ 300,000 in the annual aggregate, or an unexpired, irrevocable letter of credit in an amount not less than $ 100,000 per claim or $ 300,000 in the aggregate.

We have included a copy of Florida’s law (S 459. 0085 Fla. Stats. )

The AMA reports that seven states requires physicians to maintain minimum levels of malpractice insurance, ranging from $ 100,000 to $ 1,000,000 per occurrence and $ 300,000 to $ 3,000,000 in the aggregate each year. In addition, it reports that at least five states require physicians to carry minimum levels of insurance to qualify for state liability reforms, including damage caps. The AMA notes that although many states do not require malpractice insurance, as a practical matter, physicians usually must have it to obtain hospital staff privileges and participate in health plans. We have enclosed information from the AMA on these states.

Please let us know if you need additional information.

GC: ro