New damage caps in medical malpractice

Nixon signs law at Jefferson City hospital

Flanked by doctors from St. Mary's Hospital, Gov. Jay Nixon signed new legislation Thursday regarding medical malpractice. The legislature renewed malpractice restrictions after the previous ones were overturned by the Missouri Supreme Court.
Flanked by doctors from St. Mary's Hospital, Gov. Jay Nixon signed new legislation Thursday regarding medical malpractice. The legislature renewed malpractice restrictions after the previous ones were overturned by the Missouri Supreme Court.

Missouri Gov. Jay Nixon has signed the bill setting new limits on non-economic damages in malpractice cases.

In ceremonies Thursday afternoon at Jefferson City's St. Mary's Hospital, Nixon said his signing marked "the successful completion of a bipartisan effort to make sure that our health care providers can continue to do what they do best - helping heal Missourians in need."

"The governor's been with us, working on trying to make a fix," said Sen. Dan Brown, R-Rolla, sponsor of the bill. "I think it's probably just about right for the people of the state of Missouri.

"And I think this does translate into less health care cost - which is what we're all trying to reach and move toward."

St. Mary's President Brent VanConia noted the new law provides a "permanent fix to medical malpractice insurance" and called that "a positive step for the medical community."

Nixon recalled the effort to pass the new law began after a 2012 Missouri Supreme Court ruling that the $350,000 damages cap set by a 2005 law violated Missourians' "right to trial by jury."

The new law declares medical malpractice cases are statutory and not a common law cause of action. Supporters have said they believe that change will provide courts with a reason to back the new limits.

It also sets differing caps - $400,000 in most medical personal injury cases and $700,000 for wrongful death cases and for catastrophic cases defined by the new law, including paralysis, loss of vision and brain injury.

And it has an inflation factor - no more than 1.7 percent a year.

As in the past, measurable economic damages, such as medical costs resulting from the injury and lost wages, would not be subject to the limits.

But House Minority Leader Jake Hummel, D-St. Louis, is among those who oppose any caps because, he said, juries should be able to make those decisions rather than bureaucrats in Jefferson City.

"I don't think you should put a dollar figure on a person's life," he told the Associated Press.

Nixon said the high court's ruling in 2012 "underscored the fact that the existing, fixed limits on damages were insufficient to meet some patients' needs. On the other hand, this decision resulted in a new problem - by creating a climate of financial uncertainty for health care providers."

Nixon emphasized the new law resulted from negotiations involving lawmakers from both political parties as well as representatives of numerous professional and other interest groups.

"A lot of good minds have been around it," he explained. "When you get legislation that's crafted from people who disagree, that generally turns out to be pretty good legislation - because you have empowered forces all the way around the table."

The 2005 law replaced caps that had been set in the mid-1980s, but had grown through inflation to almost $600,000.

"This is something that can, I think, stand the test of time," Nixon told reporters. "Having something where folks can see what the risks are and see what the costs are, and align the premiums accordingly, means you can flatten those premiums into a predictable curve."

Most of the doctors witnessing the ceremony came from St. Mary's staff.

But Dr. Ravi Johar, an OB/GYN specialist at Mercy Hospital in St. Louis County and the Missouri State Medical Association's president-elect, came to Jefferson City for the ceremonies.

"The importance is, this bill is going to make it possible for physicians to keep practicing in Missouri," he said. "I was involved with the (2005) tort reform effort.

"And I saw a lot of my colleagues leave and I saw patients coming in from far-away communities, because they didn't have obstetricians anymore."

Johar agreed with Nixon that the new law should help stabilize the malpractice rates doctors pay to insurance companies.

"It's probably the biggest single expense we have in our practices," he said. "Part of the problem physicians have is, there's such a range (of rates). ...

"I think the highest rate I've ever heard of was $328,000 a year for a neuro-surgeon. For some specialties it may be as low as $10,000-$12,000. From an OB/GYN's standpoint, $60,000-$100,000 is very normal - and I've heard some of my colleagues had $250,000 policies."