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Four bills in Congress address liability questions
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W a s h in g t o n R e p o r t
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Four bills in Congress address liability questions ithout pausing for waiting photo graphers, Sen. Orrin H atch (R-UT) slipped quietly into a Senate hearing room this fall to introduce representatives of the American Dental Association, American Medical Association, and American College of Nurse-Midwives to a small group of reporters. The press was there to hear about a new bill, the Federal Incentives for State Health Care Professional Liability Reform Act of 1985 (S 1804), and Sen. Hatch, chairman of the Labor and Human Re sources Committee, was there to an nounce plans to introduce it, the major malpractice measure offered in the 99th Congress. The Hatch bill, however, by vir tue of its provisions, if not the quiet power of its sponsor, promised to set the ground rules for the malpractice debate in Con gress in 1986. “This legislation is going to give credi bility to the problem,” said Dr. Leslie W. Seldin, a New York City dentist and member of ADA’s Council on Insurance, whose Capitol Hill appearance was but one manifestation of the Association’s in creasing response to problems of profes sional liability. ADA House of Delegates last month devoted a great deal of atten tion to professional liability issues. The Association’s Washington Office has coordinated the profession’s re sponses to Congress on proposed mal practice legislation.
$1,650. In some high risk areas, such as Dade County, FL, premiums may be in creased as much as 900%. • Some dental specialists, such as oral surgeons practicing in certain locations, have seen their premiums balloon in re cent years. For example, oral surgeons in New York State have experienced in creases from an average of $2,000 in 1984 to between $12,000 and $24,000 today. Some New York City oral surgeons are paying more than $60,000 in annual pre miums. • The average award for a dental mal practice suit in 1978 was $6,600. By 1982 it was $20,000. • The incidence of claims against den tists has increased to a point at which it is expected that eight of every 100 dentists will have malpractice claims brought against them. Congress, paying increasing attention to such reports, is considering four regu latory responses to the problems. Pending in the Senate are Sen. Hatch’s S 1804, cosponsored on its introduction by Sen. James Abdnor (R-SD) and Sen. Daniel K. Inouye (D-HI), and Sen. Inouye’s own bill, S 175, the Health Care Protection Act of 1985. In the House, Rep. Robert Mrazek (D-NY) has introduced HR 2659, the Med ical Malpractice Reform Act, and Rep. W. Henson Moore (R-LA) and Sen. Richard A. Gephardt (D-MO) are cosponsoring HR 3084, the Medical Offer and Recovery Act. HR 3084 would establish an alternative system for settlement of malpractice claims resulting from health care pro vided through federal programs, includ ing Medicare, Medicaid, and CHAMPUS (Civilian Health and Medical Program of the Uniformed Services). It would apply only to dentists providing services through federal programs. This bill also would encourage state reforms.
medicine,” which he defined as ove treatment of patients by practitioners trj ing to protect themselves. The purpose of S 1804, said Sen. Hate] is “to address the rising trend toward d fensive medicine due to the problem i increased medical malpractice litigatic and the resulting additional expense an the sometimes unavailability of medic, liability insurance for physicians, dei tists, nurse-midwives, and other heall professionals. This poses a serious thre, to the accessibility of affordable healt care services to the American public.” The bill would provide grants to state to improve their malpractice compens; tion and professional disciplinary sy tems through four recommended tort r forms and four recommended administri tive changes. The tort reforms would provide fc periodic payment of damage awards ov< $100,000; eliminate the collateral sourc rule, thus providing for the reduction ( awards received from other sources f( the same injury; limit noneconomic dan ages (for pain and suffering) to $250,001 and limit attorneys’ contingency fees. Call for peer review
The bill also calls on states to increas peer review of questionable health car practices; allocate amounts collecte from licensing fees for health profe sionals to the agency responsible for di ciplinary actions; require hospitals to de velop risk management programs, an require insurance companies to make ce: tain data available to state agencies. “The organizations represented her today and I recognize the fact that ma practice does exist,” said Sen. Hatcl flanked by ADA’s representative, Dr. Se din, and the AMA and nurse-midwif representatives. “The legislation I’m o fering will strengthen the ability and re sources of state boards to weed out ir Similar bills competent health practitioners while ac The o th er th re e b ills have m ore dressing the problem of soaring media similarities, although each has variations. professional liability insurance cost They would encourage the states, with This situation is not limited to physician government grants, to enact reforms in and dentists,” he said. the tort system for settlement of malprac “This measure is meant to highlight th tice claims and to make administrative problems and begin in earnest the searc reforms. The creation of state screening or for the appropriate federal and states role arb itratio n panels of at least three in malpractice reform.” members—health professional, attorney, His statement concluded, Sen. Hate lay person—to hear all claims of health excused himself, turned the meeting ove care malpractice would be encouraged by to the health professionals, and left a Problems outlined HR 2659 and S 175. quietly as he arrived, closing the hearin The dental professional liability prob Sen. Hatch said his bill is intended not room door, while opening a door on con lems, briefly, are these: to cover up malpractice but to reduce the gressional debate of professional liability • Liability insurance premiums forcosts associated with it for patients and issues. dentists were increased an average 300% professionals. He referred several times at this year. For the average general dentist the Capitol Hill briefing to what he said T his report was prepared by Mr. Craig Palmer, put this represents an increase from $415 to was an increasing use of “ defensive lie inform ation counsel, ADA W ashington Office. 1036 ■ JADA, Vol. I l l , D ecember 1985
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W a s h in g t o n R e p o r t
...
Four bills in Congress address liability questions ithout pausing for waiting photo graphers, Sen. Orrin H atch (R-UT) slipped quietly into a Senate hearing room this fall to introduce representatives of the American Dental Association, American Medical Association, and American College of Nurse-Midwives to a small group of reporters. The press was there to hear about a new bill, the Federal Incentives for State Health Care Professional Liability Reform Act of 1985 (S 1804), and Sen. Hatch, chairman of the Labor and Human Re sources Committee, was there to an nounce plans to introduce it, the major malpractice measure offered in the 99th Congress. The Hatch bill, however, by vir tue of its provisions, if not the quiet power of its sponsor, promised to set the ground rules for the malpractice debate in Con gress in 1986. “This legislation is going to give credi bility to the problem,” said Dr. Leslie W. Seldin, a New York City dentist and member of ADA’s Council on Insurance, whose Capitol Hill appearance was but one manifestation of the Association’s in creasing response to problems of profes sional liability. ADA House of Delegates last month devoted a great deal of atten tion to professional liability issues. The Association’s Washington Office has coordinated the profession’s re sponses to Congress on proposed mal practice legislation.
$1,650. In some high risk areas, such as Dade County, FL, premiums may be in creased as much as 900%. • Some dental specialists, such as oral surgeons practicing in certain locations, have seen their premiums balloon in re cent years. For example, oral surgeons in New York State have experienced in creases from an average of $2,000 in 1984 to between $12,000 and $24,000 today. Some New York City oral surgeons are paying more than $60,000 in annual pre miums. • The average award for a dental mal practice suit in 1978 was $6,600. By 1982 it was $20,000. • The incidence of claims against den tists has increased to a point at which it is expected that eight of every 100 dentists will have malpractice claims brought against them. Congress, paying increasing attention to such reports, is considering four regu latory responses to the problems. Pending in the Senate are Sen. Hatch’s S 1804, cosponsored on its introduction by Sen. James Abdnor (R-SD) and Sen. Daniel K. Inouye (D-HI), and Sen. Inouye’s own bill, S 175, the Health Care Protection Act of 1985. In the House, Rep. Robert Mrazek (D-NY) has introduced HR 2659, the Med ical Malpractice Reform Act, and Rep. W. Henson Moore (R-LA) and Sen. Richard A. Gephardt (D-MO) are cosponsoring HR 3084, the Medical Offer and Recovery Act. HR 3084 would establish an alternative system for settlement of malpractice claims resulting from health care pro vided through federal programs, includ ing Medicare, Medicaid, and CHAMPUS (Civilian Health and Medical Program of the Uniformed Services). It would apply only to dentists providing services through federal programs. This bill also would encourage state reforms.
medicine,” which he defined as ove treatment of patients by practitioners trj ing to protect themselves. The purpose of S 1804, said Sen. Hate] is “to address the rising trend toward d fensive medicine due to the problem i increased medical malpractice litigatic and the resulting additional expense an the sometimes unavailability of medic, liability insurance for physicians, dei tists, nurse-midwives, and other heall professionals. This poses a serious thre, to the accessibility of affordable healt care services to the American public.” The bill would provide grants to state to improve their malpractice compens; tion and professional disciplinary sy tems through four recommended tort r forms and four recommended administri tive changes. The tort reforms would provide fc periodic payment of damage awards ov< $100,000; eliminate the collateral sourc rule, thus providing for the reduction ( awards received from other sources f( the same injury; limit noneconomic dan ages (for pain and suffering) to $250,001 and limit attorneys’ contingency fees. Call for peer review
The bill also calls on states to increas peer review of questionable health car practices; allocate amounts collecte from licensing fees for health profe sionals to the agency responsible for di ciplinary actions; require hospitals to de velop risk management programs, an require insurance companies to make ce: tain data available to state agencies. “The organizations represented her today and I recognize the fact that ma practice does exist,” said Sen. Hatcl flanked by ADA’s representative, Dr. Se din, and the AMA and nurse-midwif representatives. “The legislation I’m o fering will strengthen the ability and re sources of state boards to weed out ir Similar bills competent health practitioners while ac The o th er th re e b ills have m ore dressing the problem of soaring media similarities, although each has variations. professional liability insurance cost They would encourage the states, with This situation is not limited to physician government grants, to enact reforms in and dentists,” he said. the tort system for settlement of malprac “This measure is meant to highlight th tice claims and to make administrative problems and begin in earnest the searc reforms. The creation of state screening or for the appropriate federal and states role arb itratio n panels of at least three in malpractice reform.” members—health professional, attorney, His statement concluded, Sen. Hate lay person—to hear all claims of health excused himself, turned the meeting ove care malpractice would be encouraged by to the health professionals, and left a Problems outlined HR 2659 and S 175. quietly as he arrived, closing the hearin The dental professional liability prob Sen. Hatch said his bill is intended not room door, while opening a door on con lems, briefly, are these: to cover up malpractice but to reduce the gressional debate of professional liability • Liability insurance premiums forcosts associated with it for patients and issues. dentists were increased an average 300% professionals. He referred several times at this year. For the average general dentist the Capitol Hill briefing to what he said T his report was prepared by Mr. Craig Palmer, put this represents an increase from $415 to was an increasing use of “ defensive lie inform ation counsel, ADA W ashington Office. 1036 ■ JADA, Vol. I l l , D ecember 1985