Amid new proposals from lawmakers and doctors, Gov. Robert L. Ehrlich Jr. said yesterday that he is more optimistic than ever that the General Assembly will adopt medical malpractice reforms in a special legislative session this month.
Ehrlich said at a meeting of the state Board of Public Works that he and legislative leaders had resolved all but two of three dozen points of contention in attempting to avoid a 33 percent average increase in malpractice insurance premiums set to hit most Maryland doctors in January.
The bad news, he said, was that the remaining issues are "major." Sticking to a policy of not negotiating in public, the governor did not identify the issues in dispute, but the administration and General Assembly leaders remain divided on the source of money for a fund to eliminate short-term premium increases.
"Last week was a turning point in my mind," Ehrlich said. "I do see today a path toward a special session in December."
Yesterday, when the first installments for next year's malpractice premiums were due for most of the state's physicians, a group of doctors released new proposals to limit malpractice lawsuits and a Senate task force completed its recommendations for malpractice reforms.
Threaten to leave
Doctors have warned that without reforms to stave off future premium increases, many physicians, particularly in high-risk specialties such as obstetrics, would leave the state, retire or change the way they practice medicine.
Doctors insured by the Medical Mutual Society of Maryland - about three-quarters of the state's physicians in private practice - have until Jan. 1 to make payments or their policies will be canceled.
The Senate task force made five recommendations for limits on lawsuits, known as "tort reform."
The proposals are:
Mandatory mediation before cases go to court.
Reducing the amount that can be paid for non-economic damages in a wrongful-death case to $975,000 from $1.6 million.
Eliminating annual increases in the non-economic damages cap for the next three years.
Barring lawyers who file three frivolous malpractice cases in five years from bringing malpractice claims for another 10 years.
Making a doctor's apology to a patient inadmissible in court.
"I guarantee you're going to walk out of this room and you're going to hear from lawyers that it's too much tort reform, and doctors are going to tell you it's too little," said Sen. Brian E. Frosh, the Montgomery County Democrat who chaired the task force.
Senate President Thomas V. Mike Miller has been the chief opponent of Ehrlich's efforts to enact sweeping limits on malpractice lawsuits, and the task force's recommendations do not go as far as the governor's proposals.
However, Donald J. Hogan Jr., the governor's point man on malpractice reform, said he thought the senators' recommendations amounted to progress.
"They didn't discuss some other tort reform we think is important. I don't know if that's because they rejected it or just didn't discuss it," Hogan said, pointing to limits on attorney's fees and extensions on settlement payments.
"I'd say what they've done today is a step in the right direction," Hogan added.
The senators endorsed a plan to use a 2 percent tax on HMO premiums to pay for a fund that would limit premium increases for the next four years. The rest of the money generated by that tax would go toward increasing Medicaid reimbursements. Hogan said the governor remains opposed to an HMO tax.
A physician group, Save Our Doctors, Protect Our Patients, released its own set of proposals yesterday. These included reducing non-economic damages for medical malpractice to $500,000, down from the current $650,000, in all cases except wrongful death. The group also wants to limit attorneys' fees and create a panel of experts to assess damages in malpractice cases.