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1. Louisiana Medical Malpractice An Overview2010 HOD
Vince Culotta Jr. MD
2. Before Act 817 No limits
Ad damnum clause
Crisis of availability
1974 constitutional convention
Sensational journalism
Trial by press
Reputations ruined
3. Act 817 No ad damnum clause
Pre-trial Review Panels
Limited liability to $500,000 total
Personal limit of liability to $100,000
Established PCF to pay claims in excess of $100,000 and receive complaints and determine qualifications
4. Evolution of the ACT Allowed settlement less than $100,000 to establish liability & PCF hands OFF
Roemer commission established unlimited payments for future medicals.
PCF oversight board.
Actuarial requirements applicable to PCF
Thirty percent requirement
250 legislative challenges to act
Filing fees & Modified loser pay rules
5. Forces affecting ACT 817 Court decisions in progress
Taylor
Arrington
Olivier
Insurance commissioner
Rapid rise in the rate of increase
Concern for the unfunded liability
Desire to privatize
Legislation
Trail Bar
REP. John Bel Edwards
Attempts at compromise
6. Court Decisions Taylor & Arrington case
Olivier case
Texas Act
Constitutional concerns by many
Work group of the interested
7. Louisiana Constitution ‘74 §22. Access to Courts
Section 22. All courts shall be open, and every person shall have an adequate remedy by due process of law and justice, administered without denial, partiality, or unreasonable delay, for injury to him in his person, property, reputation, or other rights.
8. Insurance commissioner Afraid of another Citizens
Unfunded liability (400mil)
530 mil in bank
Wants to close the UFL in 5 – 7 years
20% increase for 5-7 years
DOI is suing the PCF
Legislative battle is looming
9. La RS 40:1299.44 (6)(a) At all times the fund shall be maintained so as to provide a surplus of thirty percent of the annual surcharge premiums, reserves established for individual claims, reserves established for incurred but not reported claims, and expenses.
(b) No reduction in the surcharge shall be made unless such surplus is available in the fund
10. The PCF Closing more claims than opening
Interest is a problem
No Knowledge of claim until underlying coverage is resolved
Unfunded liability calculated to be 400 MIL
Based on average with little facts
Reserves >30%
11. La RS 40:1299.44 (2)(b) The surcharge shall be determined by the commissioner of insurance based upon actuarial principles and in accordance with an application for rates or rate changes, or both, filed by the Patient's Compensation Fund Oversight Board, established and authorized pursuant to Subsection D of this Section.
12. Legislation Working for one year with stakeholders
Trial bar gave nothing
Providers offered much
Expect cap bills and prepare to be involved
The LSMS has worked in good faith
13. LSMS Actions Ad hoc committee
Member of the work group
Authorization for COM and underlying coverage increase
Monitoring and working to represent all MDs insured, self insured and hospital based reflecting the membership
14. 2008 Attempts at change by Coalition SB509/SB70 Definitions of malpractice
SB652 PCF adjustments
HB658/SB217 willful & wanton
SB664/HB881 C.O.M.
SB302?HB555 Claims made/ tail
SB661 250000 non-economic cap, 250,000 underlying, PCF layer 500,000-750000. Future meds 2,000,000
HB826/SB320 constitution amendment for caps
16. What has to be done?? Participate
Follow the session
Calls
Emails
Contacts
Will Medicine will be divided?
17. The future Change will happen!
Who drives the change?
What will we gain?
What will we lose?
Who will be the losers?
Will there be caps?
What will be capped?
18. Information www.legis.state.la.us
www.lsms.org
www.lammico.com
www.lapcf.state.la.us
van@culotta.net