Assembly negotiators agree on liability bill

Md. lawmakers defy Ehrlich, who has vowed a veto

some see enough votes to override

Would limit insurance increases

December 30, 2004|By M. William Salganik, Joanna Daemmrich and David Nitkin | M. William Salganik, Joanna Daemmrich and David Nitkin,SUN STAFF

House and Senate negotiators pulled together an agreement late last night to keep malpractice insurance costs for doctors in check, defying Gov. Robert L. Ehrlich Jr.'s pledge to veto the complex legislation.

The compromise by a joint conference committee, struck on the second day of a rare General Assembly special session, would limit doctors' insurance increases at 5 percent in the coming year instead of the 33 percent increase that they face Saturday. Other reforms were worked out to make patients safer, discipline negligent doctors and change the way courts award damages for injuries and improper care.

The special session called by the governor reached a climax as hours passed and legislative staffers scurried to print a final version of the 100-page bill to be presented to the Assembly for a final vote scheduled late last night.

"It appears the net result of this experience is a tax bill which is regressive and is legal-reform light," Ehrlich said last night, "which is not what the people of Maryland wanted."

Ehrlich called it "a wasted opportunity" to create more meaningful reforms. "It's a shame," he said. But the governor vowed to reintroduce more far-reaching reforms on malpractice lawsuits, as he had originally proposed, when the General Assembly reconvenes in two weeks.

As lawmakers phoned spouses to apologize for missed plans, and poured cups of coffee to stay awake, some were unsure whether they had wasted their time because of the governor's veto threat. But others maintained that something of substance had been accomplished.

"The juice was worth the squeeze to come down here, and do what we did," said Del. Joseph F. Vallario Jr., a Prince George's County Democrat and one of the House negotiators.

Vallario and others said there were sufficient votes in both chambers to override a gubernatorial veto, a vote that could come as early as Jan. 11. That's when lawmakers are scheduled to take up a series of veto overrides, a day before the start of the 90-day regular session.

Ehrlich and the Assembly remain locked in a standoff over which public funds should be used to help doctors defray their soaring costs. The Democrat-controlled legislature wants to remove a decades-old tax exemption applied to health maintenance organizations, making them subject to the same 2 percent premium tax paid by other insurers.

Ehrlich, a Republican, has repeatedly called such a tax "regressive," and his veto of the bill is virtually guaranteed. Instead, the governor wants to use a corporate tax windfall to create a stop-gap fund for doctors who say the insurance increases are forcing them to curtail care and even quit.

Legislative leaders insisted they were proud of their work over the past three days to balance the desires of trial attorneys, hospitals, doctors and patient victims.

"I'd like to think the governor will have time to reflect on this bill and see the good it does for the people of Maryland," said Senate President Thomas V. Mike Miller. He called the agreement "almost miraculous."

Likewise, House Speaker Michael E. Busch said Ehrlich should be pleased with the limits on jury awards and expert witnesses contained in the final plan, because it includes much of the legal reforms Republicans have long championed.

Sen. Brian E. Frosh, a Montgomery County Democrat and key negotiator of the compromise, called the consensus package "a comprehensive approach to the problem - balanced, effective and fair." He said it would reduce future litigation costs more than the version offered last week by the governor.

Del. John Adams Hurson, the chairman of the House Health and Government Operations Committee, said it included "major pieces of tort reform," and stronger patient safety and insurance reform measures than the governor's bill.

Key provisions of the bill include:

Pay-outs: The limit on so-called pain and suffering noneconomic damages would be locked in at the current $650,000, ending an annual inflation adjustment. In death cases, the limit would be set at $812,500 - half the current level. Courts could use neutral experts to assess lost wages and future medical costs.

Process: There would be tighter limits on qualifications of expert witnesses, and plaintiffs would have to file a more detailed "certificate of merit" with an expert explaining what he thought the doctor had done wrong. Apologies made by doctors couldn't be used as evidence against them, although admissions of fault could be. Mediation would be mandatory, in an effort to settle more cases before expensive trials.

Reimbursement: To help doctors meet higher costs and to provide incentive to treat the poor, doctor reimbursements under Medicaid would be increased, with the decision on how to set the enhancements left to the state health department.

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