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PLUS Medical Professional Liability Symposium. D, Brent Mulgrew Executive Director OSMA. March 11, 2003. OSMA Value. Image. Advocating for physicians Promoting a positive image Practice services that save time and money. Value & Loyalty. Practice Services. Advocacy.

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plus medical professional liability symposium

PLUS Medical Professional Liability Symposium

D, Brent Mulgrew

Executive Director

OSMA

March 11, 2003

osma value
OSMA Value

Image

  • Advocating for physicians
  • Promoting a positive image
  • Practice services that save time and money

Value

& Loyalty

Practice Services

Advocacy

Zero Cost of Membership

what we re seeing in ohio
“Soaring malpractice premiums stun many doctors”…USA TodayWhat we’re seeing in Ohio

“Family physician to give up obstetrics”

…Health Headlines

“Professional liability rates go up; doctors

go away”…AMNews

what we re seeing in ohio1
What we’re seeing in Ohio

“Malpractice-insurance rates in Cleveland among highest in nation”…Cleveland Plain Dealer

“Malpractice coverage hikes slam doctors”

…Columbus Business First

“No cure for rising costs...malpractice

insurance skyrockets”…Akron Beacon Journal

what we re hearing in ohio
What we’re hearing in Ohio

“My premium with Medical Assurance, even with

my 15½% loss free discount, is going from

$33,000 to $45,000 (+40%).”…Ob/Gyn, Cincinnati

“Our practices have been billed 50-70% higher

premiums this year for malpractice

insurance.”…Multi-specialty IPA, southeast Ohio

“Premiums are rising so fast that a change in

careers or retirement become the only options.”

…General Surgeon, Mt. Vernon

what we re hearing in ohio1
What we’re hearing in Ohio

“The rates for our group just doubled for no good

reason. Our claims rate has not changed.”

…Radiologist, Dayton

“One of my partners was forced to retire due to the

rise in malpractice rates!”…Urologist, Akron

“My malpractice rates just doubled! I’d call that a

crisis!”…Ob/Gyn, Maumee

the ohio physician s experience
The Ohio physician’s experience

10-Year

Soft PLI Market

St. Paul’s

Exit

MIIX

Downgrade

Tighter

Underwriting

Decreasing Medicare

Reimbursement

Seeing

More Patients

Increasing Jury

Awards

IOM Patient Safety Report

Prompt

Pay

Managed

Care

HIPAA

Down

Coding

the impact
The impact…
  • Increased expenses
  • Time poverty
  • Revenue remains flat to declining
  • Reduced income
  • Decreased access to patient care
    • discontinuing some procedures (96%)
    • leaving for less litigious areas (15%)
    • quitting the practice all together (51%)
ohio s pli history
Ohio’s PLI History
  • 1974-75 PLI availability disappears
  • OSMA’s response: Omnibus HB 682-Medical
    • Multiple tort reform provisions-4yr S/L, Pretrial Arb, limitations on experts, voluntary arb. 250K cap
      • most sections declared unconstitutional 1980
    • OSMA establishes physician owned PLI company
    • Multiple entrants in marketplace by1980-Availability increasing, price increases slow to inflation
  • 1982-86 Market tightens, prices spike
  • OSMA’s response: Broad based Tort Reform
    • include business coalitions
history
History
  • 1990--Held unconstitutional, but prices stable
  • OSMA’s response: 1995 HB 350 Broad based Tort Reform--Unconstitutional 1999
    • Do you detect a pattern??
    • Without changing the Supreme Court--legislation is useless
  • 2001-02 Market deteriorates as prices spike and availability disappears
the osma s response
The OSMA’s response…
  • Governor’s Task Force
  • Passed SB 281
  • Communication with ODI
  • PLI Carriers’ Roundtable
  • Providing PLI Carriers’ Ratings
  • Providing Access to independent PLI agent
senate bill 281
Senate Bill 281
  • Limits noneconomic damage awards in the vast majority of cases to $350,000
senate bill 2811
Senate Bill 281
  • Requires attorney contingency fees to be reviewed by a probate court if the fees exceed the noneconomic damage awards
senate bill 2812
Senate Bill 281
  • Establishes a statute of repose
senate bill 2813
Senate Bill 281
  • Protects physicians from the notice of a claim being used against him/her
senate bill 2814
Senate Bill 281
  • Allows evidence of collateral source payments
senate bill 2815
Senate Bill 281
  • Provides for periodic payment of future damages
senate bill 2816
Senate Bill 281
  • Strengthens Ohio’s current arbitration law
related tort reform legislation
Related Tort Reform Legislation
  • Senate Bill 120
    • Removes joint and several liability
    • In other words, in most cases, a physician who is named in a suit will only be held liable for the portion of the claim for which he or she may be responsible
  • Senate Bill 179
    • Provides a broader base of peer review protections
    • Allows health-care entities outside the traditional hospital setting to establish peer review committees
    • The activities are protected from discovery during litigation
impact
IMPACT
  • No reduction in rates or trend
    • Increased numbers of failure to renew
    • Selective underwriting of risks/specialties
    • Increased demand for hospital provided ins.
    • Credit history/psychological prescreens
    • Creation of new nonstandard market options
    • Risk retention groups, off shore or friendly state captives and OWAs.
    • Ohio Hospital Assn. Creates new options for physicians through their institutions