States Wrestle with Malpractice Reform Proposals

Published April 1, 2004

New Jersey

Physicians attending a February hearing urged the New Jersey Board of Medical Examiners to lobby state legislators to reduce the minimum level of malpractice insurance physicians are required to maintain. Doctors say reducing the mandated level of insurance will lower premiums.

According to Ruth Schulze, an OB/GYN, doctors are having to pay premiums as much as 84 percent higher than what they paid last year for the same insurance. Local hospitals have lost 20 to 35 percent of their obstetrical staff because doctors have stopped practicing or have left the state because of high insurance costs.

Last June, the Medical Society of New Jersey (MSNJ) had asked the board to reduce the required levels of malpractice coverage from $1 million per case and $3 million per year to $300,000 per case and $900,000 per year.

Dr. Mark Olesnicky, president of MSNJ, suggested the money not spent on inflated premiums could be used to hire needed staff or purchase new equipment.

The proposal, however, was criticized by lawyers, the New Jersey Hospital Association, and patients who have been victims of medical malpractice.


The Connecticut General Assembly Legislative Program Review and Investigations Committee held a public hearing in February on several bills to reduce malpractice insurance premiums.

The committee heard testimony regarding measures that include creating a $3 million emergency fund for doctors unable to pay their malpractice premiums; requiring physicians to take competency tests to renew licenses; creating an independent panel of doctors and lawyers to review malpractice claims before they go to court; and requiring the state Insurance Department to approve premium rate increases.

Insurance Commissioner Susan Cogswell testified she favored a cap on pain-and-suffering jury awards. She also said review panels may not be practical because of the large number of malpractice suits being filed, and that requiring insurance carriers to get approval from the Insurance Department for proposed rate increases would simply drive insurers out of the state.


In January, the Kentucky House of Representatives passed House Bill 450, which would create a state-sponsored company to sell malpractice insurance to health care providers; establish panels to review malpractice claims before they went to court; and require all malpractice suits to go through mediation before going to court. The bill is now in the Senate.

In February, the Senate passed Senate Bill 1, which would create a constitutional amendment enabling the General Assembly to cap damage awards in malpractice lawsuits and make other malpractice reforms. The House version of the bill has been in committee since January.

Since each chamber now has control over malpractice bills originating in the other chamber, a compromise measure may be forthcoming.


The Nevada Board of Medical Examiners (BOME) plans to take steps to keep the public informed of its efforts on physician discipline, according to Keith Lee, an attorney for the board.

In the near future the BOME Web site will list the names of physicians disciplined by the board, along with their alleged violations. In addition, the board will send written responses to individuals who file complaints against physicians and inform them of hearings that involve their complaints.

The BOME measures are intended to address concerns raised by a review conducted recently by the Federation of State Medical Boards. While the review generally found BOME meets or exceeds its statutory responsibility to regulate the medical profession in the state, it also determined hospitals in the state do not adequately report medical errors and cited strained relations between the board and the Nevada State Medical Association, which represents physicians.

Conrad F. Meier is managing editor of Health Care News. His email address is [email protected].