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Practice Beat


Tort reform; Docket watch; Malpractice rates; Quality care; Access to care


Practice Beat

Joan R. Rose


No more shopping for friendly juries

Plaintiffs' attorneys in Pennsylvania will no longer be able to shop around for a friendly venue in which to try their cases. The General Assembly has passed—and the governor has signed—a bill that requires medical malpractice actions to be brought only in the county in which the alleged malpractice occurred. Just recently, Mississippi enacted a similar law ("Practice Beat," Nov. 8, 2002).

The American Tort Reform Association is also pushing for national venue reform. ATRA recently released a report, "Bringing Justice to Judicial Hellholes," which identifies 11 cities, counties, and judicial districts that attract lawsuits from outside their areas because they are perceived as plaintiff-friendly.


America's "judicial hellholes"

Alameda County, CA Los Angeles County, CA San Francisco County, CA Madison County, IL Orleans Parish, LA 22nd Judicial District, MS
St. Louis, MO Hidalgo County, TX Jefferson County, TX Nueces County, TX Starr County, TX

Source: American Tort Reform Association



Now PPO physicians must also face scorecards

In recent years, insurers' efforts to measure quality have focused primarily on care provided by HMOs. Now Blue Cross of California is turning its attention to PPOs.

The Blue Cross plan is launching a one-year pilot program that will set quality measures—such as reducing the incidence of mortality associated with chronic conditions—and reward physicians who meet those standards.


Doctors' liability issues are worrying the public, too

Pennsylvanians fear that doctors' rising malpractice insurance costs will impact their own health costs and reduce the availability of care. According to a new study conducted for The Project on Medical Liability in Pennsylvania, nine out of 10 small-business owners there say they may be forced to switch workers to a health plan with minimal coverage, or drop health benefits altogether.

Two-thirds of adults polled worry about their ability to find a doctor when needed, and three out of four fear it will be more difficult to get specialty care. Both patients and employers cite excessive litigation and overly generous awards as the primary culprits in driving up malpractice costs.


Adult medicines don't have to be tested on kids

A US District Court has thrown out the FDA's 1998 "pediatric rule," which required drug companies to test the safety and efficacy of all new medicines on children—even if the proposed labeling indicated it was meant for adults only. Judge Henry Kennedy pointed to a 1992 speech by former FDA Commissioner David Kessler, in which he cited the limits of the FDA's authority: "It is our job to review drug applications for the indications suggested by the manufacturer. We do not have the authority to require manufacturers to seek approval for indications which they have not studied."


Missouri's governor to insurers: "Show me" the crisis

Insurance conditions in Missouri don't warrant the kind of premium increases and availability problems that Missouri doctors are facing, Gov. Bob Holden told doctors at a meeting of the Cape Girardeau Medical Society. According to the state's annual medical malpractice insurance report, Holden noted, the number of new claims against Missouri doctors dropped 37 percent in 2001, while the number of companies writing coverage there rose from 27 to 32. Moreover, among claims closed in 2001, average awards dropped more than 8 percent for economic damages and more than 10 percent for pain and suffering. Consequently, Holden has asked the state insurance department to find out why rates are rising so sharply.

A new study by Americans for Insurance Reform (a coalition of consumer and public interest groups) refutes the insurance industry's explanation that increasing malpractice claims have created the need for higher premiums. Over the past 30 years, the group contends, malpractice premiums have been affected more by the ups and downs of the economy and the insurers' "own investment actions" than by actual payouts.


The author is a Contributing Writer.


Joan Rose. Practice Beat. Medical Economics Dec. 9, 2002;79:19.

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