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House votes to implement malpractice law

March 24, 2005|by TAMELA BAKER

tammyb@herald-mail.com

ANNAPOLIS - The House of Delegates approved legislation Wednesday evening to implement the medical malpractice law approved in January, opening the door to reimbursements for physicians stung by mounting costs for malpractice insurance.

The bill originated in the Senate, where it was approved on March 14.

Technical issues with the law as passed in January had delayed its going into effect. The law, designed to provide emergency relief to physicians threatening to cut back their practices or stop practicing altogether, established a stop-gap fund to subsidize their malpractice premiums. The subsidies are to be paid with money raised from a 2 percent premium tax on health management organizations. But because of the problems, doctors have not yet seen relief for their malpractice insurance costs.

The law was hotly debated during a special session of the General Assembly in December. Gov. Robert Ehrlich vetoed the legislation, saying it didn't do enough to reform malpractice laws, only to have the legislature override the veto on the day before the regular session started in January.

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Opposing views have continued to collide throughout the session, and Republicans attempted Wednesday to add amendments to the implementation bill that would undo some of the provisions of the original legislation.

House Minority Whip Anthony O'Donnell attempted to amend the corrective bill to divert $10 million from the stop-gap fund to Medicaid reimbursement. The reason for that, he said, was to allow doctors who treat Medicaid patients to collect more money for those services. The federal government would match the $10 million, he said. Physicians have complained the Medicaid reimbursement rates are far below their regular rates for similar procedures. That amendment failed.

A second amendment, proposed by Del. Adelaide Eckardt, R-Eastern Shore, would have repealed the HMO tax and paid for the stop-gap fund with new surcharges for drunk- and drugged-driving and moving violations.

She argued that HMOs passing the premium tax onto their clients would hurt families.

Del. John A. Hurson, D-Montgomery, argued that the amendment wasn't needed because insurers such as CareFirst BlueCross BlueShield had not passed the tax on to consumers, nor had Kaiser Permanente.

Maybe not, said Del. Christopher B. Shank, R-Washington. But he said a number of other insurers had.

"I do believe in free markets," Shank said, "and that includes the cost of doing business. Businesses pass on their expenses."

With fewer employers totally covering health care premiums, he said, "enough is enough."

He also seized the opportunity to resurrect complaints about the original legislation, arguing that it only offered doctors a 2 percent rate relief on their malpractice premiums while legislation Ehrlich had proposed would have provided 18 percent along with more legal reforms.

"We are subsidizing a failed legal system," he said.

And Del. John R. Leopold, R-Anne Arundel, reminded legislators that CareFirst already had won permission to raise rates last November, when the HMO tax was being discussed, "then piously announced they were not raising rates when their competition did."

But Del. Robert Zirkin, D-Baltimore County, told the House that when the implementation bill passed, the state's largest malpractice insurer, Medical Mutual Liability Insurance Society of Maryland, "will begin reimbursing doctors immediately."

Del. Shane Pendergrass, D-Howard, had the last word on the amendment, calling it an "offensive, disingenuous, harebrained scheme at the eleventh hour" to change the revenue source for the stop-gap fund.

All but three House members voted for the implementation bill, including every delegate representing Washington County.

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