The following summarizes news about recent medical malpractice developments in four states.
Missouri: The state Senate on Thursday by voice vote passed a bill (SB 905) that would require malpractice insurers to obtain approval from the state insurance director before they increase premium rates, the AP/Kansas City Star reports. In addition, the legislation would require malpractice insurers to report to the state Department of Insurance information on premium rates, losses and potential for claims and would increase penalties for those who failed to report the information. The department would use the information to publish a market rate for different forms of risk and a comparison of base premium rates charged by malpractice insurers. The bill also would require the state insurance director to ensure that malpractice insurers comprised in large part of self-insured physicians charge adequate premium rates to maintain solvency. The legislation requires approval in a second vote by the state Senate to move to the state House for consideration (Wiese, AP/Kansas City Star, 3/30).

Pennsylvania: The Pittsburgh Post-Gazette on Sunday examined how neurosurgeons in the state "cite high malpractice insurance costs as one reason why some decide to leave Pennsylvania," a trend that has contributed to a statewide shortage. According to Daniel Bursick, past president of the Pennsylvania Neurological Society, the number of neurosurgeons in Pennsylvania has decreased by about 25% since the late 1990s, when more than 200 practiced in the state. Bursick cited other factors -- such as compensation and regulatory requirements -- as contributors to the decrease, but added that "what really drives people over the edge is malpractice." The October 2005 newsletter of the Medical Liability Monitor said that Pennsylvania physicians pay some of the highest malpractice insurance premiums in the nation, according to the Post-Gazette (Fahy, Pittsburgh Post-Gazette, 3/26).

Tennessee: The state House Judiciary Subcommittee on Civil Practice and Procedure this week voted 3-2 to defeat a bill that would have capped noneconomic damages in malpractice lawsuits at $250,000 and placed new limits on attorney fees in such cases, the Knoxville News-Sentinel reports. State Rep. Rob Briley (D), who chairs the subcommittee and also chaired a legislative study on medical liability, said claims that the state faces a malpractice insurance crisis because of lawsuits are "totally subjective," adding that the legislation would unfairly penalize patients who experience injuries because of malpractice. Briley also said that the subcommittee would not reconsider the legislation this year. According to the News-Sentinel, similar bills have failed for the past four years in the state Legislature (Humphrey, Knoxville News-Sentinel, 3/29).

Texas: Many state residents who seek to file malpractice lawsuits cannot find attorneys to represent them because of a cap on noneconomic damages in such cases that took effect in 2003, the Austin American-Statesman, reports (Dexheimer, Austin American-Statesman, 3/26). In September 2003, Texas voters approved Proposition 12, a ballot measure that amended the state constitution to allow state lawmakers to pass legislation to cap damages in malpractice lawsuits. Texas in June 2003 enacted a law that caps noneconomic damages in malpractice lawsuits at $250,000 for physicians, $250,000 for hospitals, and $250,000 for nursing homes and other health care facilities. The law caps total noneconomic damages in such cases at $750,000 per plaintiff; the law does not cap economic damages. Passage of Proposition 12 ensures that the law can survive a court challenge (Kaiser Daily Health Policy Report, 9/28/04). Malpractice lawsuits can cost about $100,000 to prepare, and, as a result of the caps on noneconomic damages in such cases, many attorneys only take cases in which "a patient or survivors have suffered a large economic loss," a trend that patient advocates maintain has "exacted a high price, particularly among the very young and the very old," according the American-Statesman (Austin American-Statesman, 3/26).

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