A Senate commission studying Maryland's medical malpractice crisis gave some ground yesterday on legal changes sought by Gov. Robert L. Ehrlich Jr. (R) and endorsed the creation of a state fund that would subsidize doctors' insurance costs for the next four years.
The actions were intended to move state leaders closer to convening a special legislative session, but all parties cautioned that major points of contention remain between Ehrlich and top Democrats in the General Assembly.
In its most significant concession, the Senate panel endorsed a lower cap on damages that may be claimed for "pain and suffering" in wrongful death cases, from $1.6 million to $975,000. The move was vigorously opposed by trial lawyers, who argue that it would do little to ease doctors' escalating malpractice premiums.
Physicians insured by the state's largest malpractice carrier are facing an average 33 percent increase in bills that were due yesterday. Several appeared at the Senate meeting, voicing frustration at the state's failure to act.
Donald J. Hogan, a legislative aide to Ehrlich, said the Senate panel's support for reducing the cap represented a "positive step." But Hogan noted that there are significant differences between the Senate's posture and a bill drafted by Ehrlich.
"Hopefully, we can reach a compromise," Hogan said. "There's still work to be done."
The governor's legislation includes several additional provisions designed to curb damages available for medical expenses and lost wages for injured patients.
Doctors and insurance companies argue that the curbs are necessary because lawyers routinely inflate such costs at trial and in settlement negotiations. A bill drafted by the governor also contains a lower cap for pain and suffering in wrongful death cases: $650,000.
Significant differences also remain over how to pay for a proposed fund that could provide some relief on premiums.
The Senate panel, led by Brian E. Frosh (D-Montgomery), endorsed a 2 percent premium tax on HMOs and managed-care companies that would raise an estimated $80 million a year.
A portion of that money would be used to subsidize doctors' payments, while the remainder would be used to raise the amount paid to doctors by Medicaid, the state's insurance program for the poor.
Ehrlich has voiced general support for a state reinsurance fund to help doctors but has said he is opposed to the tax on HMOs, which is paid by other insurers. He has not publicly identified an alternative funding source.
Under the plan endorsed by the Senate, a state board would decide how to subsidize doctors' insurance premiums, taking into account different specialties and regional differences in access to care. The fund would remain in place for four years.
The other legal reforms endorsed by the Senate panel yesterday include:
