- The Washington Times - Wednesday, December 1, 2004

ANNAPOLIS — A special Senate commission yesterday approved recommendations for resolving the state’s medical malpractice crisis, including a tax on health maintenance organizations (HMOs) that Gov. Robert L. Ehrlich Jr. has said will not be considered.

The Senate’s Special Commission on Medical Malpractice Liability Insurance approved more than 20 recommendations that call for mandatory mediation in malpractice lawsuits, reducing the cap on noneconomic damages in death cases to 1.5 times the personal injury cap, and repealing an $80 million HMO tax exemption to create a fund to cover doctors’ higher malpractice insurance premiums this year.

“I think its a multifaceted approach to the fundamental problem,” said Sen. Brian E. Frosh, Montgomery County Democrat and chairman of the special commission. “I think parts of [the plan] are great and some parts of it are not so great.”

Sen. Rob Garagiola, a commission member, agreed.

“If there is another viable funding source, great,” said Mr. Garagiola, Montgomery Democrat. “Right now, we are looking at a loophole exemption that all insured products pay a 2 percent assessment and HMOs do not, that’s a viable solution. If there are alternatives, I would like to hear from the governor on what those alternatives are.”

Mr. Ehrlich, a Republican, last month said the HMO tax is “off the table.” But Senate President Thomas V. Mike Miller Jr., Prince George’s Democrat, and House Speaker Michael E. Busch, Anne Arundel Democrat, favor the tax. The government leaders are working on a bill for a proposed special legislative session this month.

Higher insurance premium payments went into effect yesterday and are to be paid in full by Dec. 31. Doctors said the rates will force them out of business or out of the state. The 33 percent increases will cost some doctors as much as $150,000 a year.

Calling yesterday a “day of reckoning,” about a dozen doctors yesterday rallied at the State House before the commission’s meeting. Several said they would not pay the increased premiums.

“I think it’s a good start,” Dr. Karl P. Riggle said of the commission’s work. “I don’t think it has gone far enough to fix the problem long term.”

Dr. Riggle, a general surgeon at Washington County Hospital, heads Save Our Doctors, Protect Our Patients, a coalition of physicians seeking medical malpractice reform.

“Medical care for Marylanders must be preserved. The time to act is now,” said Dr. Mark E. Artusio, a surgeon at Frederick Memorial Hospital who indicated he would not pay the higher premiums.

The commission, set up by Mr. Miller, a trial lawyer, yesterday recommended freezing the personal injury cap during a three-year implementation of a rate stabilization fund, suspending for 10 years any lawyer who brings three frivolous malpractice cases within five years, and allowing for an apology or expression of sympathy without acknowledging fault.

Last month, the panel agreed on calls for requiring the losing side to pay litigation costs and increasing malpractice deductibles.

Medical Mutual Liability Insurance Society of Maryland, the state’s largest insurer of doctors, has said it is suffering from a surge in malpractice payouts.

State regulators have authorized the insurer to increase malpractice-insurance premiums 33 percent by the end of the year, after having raised premiums by 28 percent last year and 10 percent in 2002.

Mr. Garagiola said state officials are considering using $30 million to $50 million in taxpayer funds to cover the higher malpractice-insurance premiums this year.

Mr. Ehrlich, who has led the reform effort, has not publicly discussed the cost or indicated how he would pay companies that insure doctors. However, the governor has said no money from the state’s general fund will be used.

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