Kaiser Daily Health Policy Report features recent developments related to medical malpractice in seven states. Summaries appear below.Delaware: A bill (SB 123) that awaits action in the state House Economic Development, Banking and Insurance Committee would provide subsidies to obstetricians and other physicians in high-risk specialties to help cover the cost of malpractice insurance, the Wilmington News Journal reports. The state Senate in June 2005 voted 18-3 to approve the legislation. State Insurance Commissioner Matt Denn on Wednesday said that the state would finance the subsidies, which would total $1.3 million in 2007, through a surcharge on excess reserves held by health care companies. The Delaware chapter of the American College of Obstetricians and Gynecologists recently endorsed the bill, Denn said. However, Joseph Hacker, chair of the legislative committee of the Medical Society of Delaware, said the group has concerns that the legislation would discourage additional medical liability reforms (Ratnayake, Wilmington News Journal, 3/2).

Idaho: State lawmakers on Feb. 17 voted to send a bill to the House that would make health care workers' "expressions of apology, condolence and sympathy," as well as explanations of what went wrong, inadmissible in court under certain circumstances in medical malpractice cases, the AP/Spokane Spokesman-Review reports. Ken McClure, a lobbyist for the Idaho Medical Association, said, "We are trying to use the law in a way that will allow physicians and patients to speak to one another more freely." Barbara Jorden, a lobbyist for the Idaho Trial Lawyers' Association, said her group largely supports the bill but believes that explanations should be permissible in court (Wallace Allen, AP/Spokane Spokesman-Review, 2/21).

Iowa: An Iowa House Human Services subcommittee on Monday denied a request from the Iowa Board of Medical Examiners that would have allowed the board to disclose the reasons behind charges of incompetence or misconduct against health care professionals, the Des Moines Register reports. The board released such information until last year, when a judge ruled that it did not have legal authority to do so until a case is decided. The judge ruled that the board could release the titles of charges, such as incompetence, and the defendants' names. The decision is being appealed by the board, which says that patients have a right to know why their doctors have been charged. It also is being appealed by a physician who argues that no information should be released until a decision is made. State Rep. Rod Roberts (R), chair of the subcommittee, said that lawmakers were "concerned about taking action that would affect a case before the court can take action" and that the Iowa Supreme Court should address the legal issues (Leys, Des Moines Register, 2/28).

Kentucky: The state Senate on Wednesday failed to win passage for a proposed constitutional amendment that would have placed caps on noneconomic damages in medical malpractice lawsuits, the AP/Lexington Herald-Leader reports. The Senate voted 21-15 in favor of the proposed amendment, but 23 votes were required. The measure, which would have required voter approval in November, would have allowed the cap to be set no lower than $250,000. There would have been no caps on economic damages for lost wages and medical costs. It also would have allowed lawmakers to create a pretrial "alternative dispute resolution" system to review claims (Schreiner, AP/Lexington Herald-Leader, 3/2).

Massachusetts: Physicians in the Boston area "are missing cancer diagnoses at a troubling rate," a trend that has led to an increase in the number of malpractice lawsuits filed against them, according to attorneys for patients and physicians in such cases, the Boston Herald reports. Currently, about 33% of malpractice lawsuits in Massachusetts allege missed diagnoses, compared with about 25% 10 years earlier, according to malpractice insurer CRICO/RMF. Most of the missed diagnoses involve cancer, the Herald reports. Attorney Robert Gabler said that Boston has "some of the best hospitals in the world and some of the very best are making some of the very worst mistakes" (Mulvihill/Fargen, Boston Herald, 3/3).

Washington: The state House on Tuesday voted 82-15 to approve a malpractice bill unanimously passed last month by the state Senate, the AP/Seattle Times reports (Woodward, AP/Seattle Times, 3/1). The legislation would make apologies to patients from health care providers inadmissible in court and would require attorneys to file certificates of merit when they file lawsuits against providers. In addition, the bill would cap noneconomic damages in malpractice lawsuits that are resolved in arbitration, rather than at trial, at $1 million. The legislation would allow the state insurance commissioner to reject proposed increases in malpractice insurance premium rates and collect data on malpractice payouts for analysis. Under the bill, state residents who report health care providers for unprofessional conduct would receive immunity, and hospitals would have to report serious patient injuries to the state. The legislation also would require the state board that disciplines physicians to include members of the public (Kaiser Daily Health Policy Report, 2/24). A spokesperson for Gov. Christine Gregoire (D) said that the governor will sign the bill into law by Monday (Shannon/Wilson, Olympian, 3/1).

Wisconsin: The state Assembly on Thursday voted 74-22 to approve a bill that would cap noneconomic damages in malpractice lawsuits at $750,000, the Milwaukee Journal Sentinel reports. State Republican lawmakers and physician groups have sought a new cap since July 2005, when the state Supreme Court struck down as unconstitutional a $445,775 cap. Gov. James Doyle (D) vetoed legislation passed late last year that would have capped noneconomic damages in malpractice lawsuits, but the margin of the state Assembly vote was "well above the two-thirds majority necessary to override a gubernatorial veto," the Journal Sentinel reports. Doyle said, "I've said all along that if I am convinced that something that comes to my desk can pass the constitutional test, I'd be willing to sign a cap" (Forster/Marley, Milwaukee Journal Sentinel, 3/2).

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