Practice Beat

Joan R. Rose

Malpractice: Legal recourse when your insurer refuses to settle

You may be able to collect damages from your professional liability insurer if the carrier refuses to settle a reasonable claim filed against you, according to a ruling by the Pennsylvania Supreme Court. The court ordered The St. Paul Cos. to pay all damages—including those to the policyholder's business, reputation, and credit—that resulted from its refusal to settle.

The ruling came in a case involving a birthing center that was sued by the parents of a child who suffered permanent brain damage during delivery. The defense attorneys' pretrial report estimated that, at best, the center had a 50 percent chance of winning at trial, and the court repeatedly recommended that the insurer settle the case. But St. Paul refused. The verdict went against the center, and St. Paul covered the loss. But the center then sued the insurer for breach of contract.

A jury awarded the birthing center $700,000 in damages.

Preventive Care: Predicting which babies are at high risk for diabetes

Physicians in every state routinely screen newborns for PKU and congenital hypothyroidism. Now Florida will become the first state to offer screening to determine an infant's lifetime probability of developing Type 1 diabetes. The parents of at-risk children will be offered the opportunity to have the child monitored for antibodies throughout his life.

The program, funded by a $10 million grant from the American Diabetes Association, is expected to launch within a year. A smaller-scale, nationally funded infant screening program for Type 1 diabetes has been under way at four hospitals in central Florida for the past four years.

Our Web Poll

On our Web site ( www.memag.com), we asked doctors how Medicaid payment rates have affected them. Three out of five respondents report that they have dropped out of the program or are considering doing so. The rest shrug off a situation they see as hopeless.

Medical Errors: What patients think about the publicity

Despite the bad press medical "errors" have received in the last two years, Americans appear less likely to sue physicians today than they were in 1996, according to polls taken by The Cromer Group, a Washington, DC-based consulting firm. Eleven percent of the respondents to last August's poll said someone in their families had considered suing over a medical mistake, but just 4 percent had actually done so. In 1996, by comparison, 19 percent considered going to court and 7 percent followed through.

But patients aren't turning a deaf ear to reports of medical mishaps. Respondents to the August 2001 poll overwhelmingly favor legislation that might help weed out unsafe doctors and help patients become better informed.

Drug Costs: One judge upholds Florida's cost-cutting tactics; another slams Michigan's

The Pharmaceutical Research and Manufacturers of America plan to appeal a federal judge's decision upholding a Florida law that restricts Medicaid patients' access to prescription drugs. The law is intended to slow Medicaid spending by establishing a "preferred drug list." This formulary includes fewer than half of all brand-name prescription drugs covered by the federal Medicaid program. The rest—more than 1,000 brand-name drugs—can be prescribed only if doctors obtain special "prior authorization" from state officials each time they want to prescribe the drug. For medications to be included in the formulary, manufacturers must agree to give the state rebates on top of those currently paid.

Meanwhile, a state court in Michigan has ruled that the state exceeded its statutory authority in creating a program loosely modeled on Florida's.

The author is a Contributing Writer.

 

Joan Rose. Practice Beat. Medical Economics 2002;5:19.