Deal near on bill for doctors' insurance

Special Assembly session likely on malpractice issue

Ehrlich to draft reform legislation

October 15, 2004|By Andrew A. Green | Andrew A. Green,SUN STAFF

A special legislative session in the coming weeks to stave off sharp cost increases for medical malpractice insurance looked likely yesterday, as the governor pledged to draft a reform bill in the next few days and legislative leaders vowed to solve the problem with or without his agreement.

Gov. Robert L. Ehrlich Jr., Senate President Thomas V. Mike Miller and House Speaker Michael E. Busch emerged from a meeting in Government House yesterday morning saying they saw room for compromise on the issues that have divided them -- the creation of a fund to hold down insurance costs for doctors and the limitation of damages in malpractice cases.

They also shared an urgency to act before a 33 percent increase in premiums goes into effect Jan. 1.

"There is real progress on this," Ehrlich said.

Miller said that he and Busch will work to get Democrats to agree to a compromise, and that Ehrlich needs to do the same with Republican lawmakers.

"If he can't, and this remains a problem, I think the speaker and I are prepared to go this alone," Miller said.

Details remain to be worked out, but the three men said the general contours of a deal would combine a new fund to hold down premiums and increase doctors' Medicaid reimbursements with reforms, including limits to jury awards, which insurance officials say are a driving factor in the premium increases.

The fund, which would likely require $20 million to $50 million to start, would stay in use for a few years while the reforms take effect, Busch said. The source of the money is still the subject of discussion. Miller has suggested a tax on HMO premiums or fines on drunken drivers, while Ehrlich has indicated a preference for using state general funds.

A draft bill should be done within a few days, Ehrlich said. After that, Miller and Busch would review the bill and discuss it with their caucuses and meet again with the governor.

Doctors, many of whom say they will have to move to another state or abandon high-risk specialties such as obstetrics and neurosurgery, have intensified their lobbying in Annapolis in recent weeks as competing task forces from the governor and legislature have looked for solutions to the problem.

Yesterday's meeting appeared to bridge some of the divide between the governor and Miller, who had been at odds over how to deal with the issue.

Ehrlich has insisted on limits to jury awards in medical malpractice cases, a top priority of President Bush and conservatives nationwide. Miller, who is an attorney, has objected to limits on patients' rights to legal redress and has advocated for a fund to hold down premiums.

Last year, the House of Delegates passed a bill that incorporated many of Ehrlich's ideas, but it died in the senate.

Yesterday, Miller acknowledged the need for long-term changes, and Ehrlich said he understands the need for a fund to stave off the immediate crisis.

"The governor's got to bring the conservative wing of his party to the table, and we've got to bring the progressive wing of our party to the table," Miller said.

Ehrlich said limits on jury awards are only one part of the long-term solutions that are under discussion, which also include new patient safety measures and insurance reforms.

Sen. Brian E. Frosh, a Montgomery County Republican and chairman of the Judicial Proceedings Committee, which would hear a reform bill, said he is encouraged that the governor is willing to consider a fund to help doctors in the short term and believes that the other issues can be worked out.

"This whole thing is complex, first of all, and second of all, there are political minefields throughout it," Frosh said. "I've heard we're trying to do it in a very compressed timeframe, so it's a very challenging task, but I believe it can be done."

Dr. Karl Riggle, a surgeon from Hagerstown who was involved in a threatened work slowdown by doctors there to protest the rate increases, said he understands that some doctors would be forced to give up their practices because of the rate increases.

But he said he and his colleagues are mostly interested in long-term reforms, such as requiring a panel of experts to sign off on a malpractice lawsuit before it is filed. Increasing Medicaid reimbursements would be a good solution because it would help relieve the financial burden on doctors while improving care for poor patients, Riggle said.

"That's good progress, I think," he said of the meeting.

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