Maryland lawmakers dealt with medical malpractice in dramatic fashion in December, crafting and passing a 79-page bill in a special session and later overriding its veto by Gov. Robert L. Ehrlich Jr.
But debate over the thorny issue is not quite over.
Sen. Andrew P. Harris, left, listens as Sen. J. Lowell Stoltzfus discusses an amendment to the malpractice bill passed in a special session last month.
(Gail Burton -- AP)
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With the General Assembly back in Annapolis for its regular session, Ehrlich (R) and lawmakers unhappy with the bill are pushing for more legal changes to limit spiraling payouts in malpractice cases. And supporters of the legislation that passed are talking about retooling a key provision designed to give doctors immediate relief from their rising insurance costs.
"We did not solve the medical malpractice problem," said Del. Robert A. Zirkin (D-Baltimore County), who plans to introduce a dozen bills this session seeking additional legal changes. "We've really just nibbled around the edges."
Despite the flurry of activity, some lawmakers remain skeptical that any new medical malpractice legislation would attract enough votes to make it through the House and Senate. The special session during the holidays, they said, left many members with limited appetites to revisit the divisive issue. And Democratic leaders, particularly those in the Senate, said they were pleased with the bill that passed.
"I think for cosmetic purposes, there might be something passed but not something very significant," said Senate Minority Leader J. Lowell Stoltzfus (R-Somerset), who is among those who would like to see additional legal curbs enacted this session. "We're going to be there, toe-to-toe, trying to get some meaningful solutions, though."
At a minimum, legislative leaders said they need to pass a bill that corrects drafting errors in the hastily assembled legislation that passed at 3:30 a.m. two days into the special session. Some said that process would open the door to far more substantial changes.
"It will be interesting to see what railroad cars go on that train," said Sen. Leo E. Green (D-Prince George's).
Lawmakers in Virginia also are considering changes to medical malpractice laws this session, including a requirement that plaintiffs find an expert to certify that a doctor violated standards of care before filing a lawsuit. Maryland has a similar provision on the books.
A chief architect of the Maryland legislation approved last month, Sen. Brian E. Frosh (D-Montgomery), said he wants to change the structure of the state fund that lawmakers set up to limit doctors' insurance increases to 5 percent this year. Maryland physicians insured by the state's largest malpractice insurer had faced an average 33 percent increase.
Under the bill that passed, the state will help insurers make payouts in malpractice cases if they agree to hold down physicians' rates -- a process that has drawn complaints from insurers, who said it is too risky. Frosh instead wants to use the money to subsidize doctors' insurance costs up front, an approach that would be simpler but could cost the state more. The change would have no immediate effect on what doctors pay, he said.
Frosh said he will seek other tweaks to the fund, such as allowing nurse midwives to benefit. The profession has been hit hard by malpractice insurance increases but is not eligible for state help under the bill passed by lawmakers, he said.
Sen. Thomas M. Middleton (D-Charles) said he will push for a broader restructuring of the fund, which is being created with proceeds from a tax on HMOs created by the bill.
Part of the money from the HMO tax will be used to boost payments to doctors who treat patients on Medicaid, the state insurance program for the poor. Middleton said he believes all the money should be steered to Medicaid rather than insurance rate-reduction for doctors.
