Pennsylvania House extends liability fund relief

Doctors hope the Senate will OK the measure, which they see as a way to keep physicians in the state.

By Tanya Albert amednews correspondent — Posted Nov. 8, 2004

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Pennsylvania doctors saddled by high medical liability insurance rates are one step closer to another reprieve from having to pay into the state fund that covers catastrophically large awards or settlements.

The Pennsylvania House in October passed a bill that would extend through 2005 and 2006 the abatement that physicians were given on their 2003 and 2004 bills from the Medical Care Availability and Reduction of Error Fund, known as Mcare.

At press time, though, the state Senate still needed to pass the bill by the scheduled Nov. 30 adjournment date before it could proceed to Gov. Edward G. Rendell's desk.

The governor won't comment on whether he will sign legislation until it's before him, a spokeswoman said. But Rendell was the one who brought the idea of an abatement for physicians to the Legislature.

When the original abatement passed, many doctors said the temporary relief from paying thousands of dollars into Mcare, which helps pay jury awards and settlements that exceed what insurance covers, allowed them to keep their practices open.

Without continued help, doctors fear they will again be forced to assess whether they can keep on practicing in Pennsylvania, one of 20 states that the AMA says is experiencing a medical liability insurance crisis. The high cost and lack of availability of insurance has forced doctors in those states to cut high-risk procedures, retire early or move out of state.

"This is extremely important," said Pennsylvania Medical Society President William W. Lander, MD. "If it doesn't pass, it means physicians are going to have to pay a heck of a lot more money. ... They would reduce work or get out of town."

Scranton general surgeon David Onofrey, MD, knows firsthand what it's like to have to decide whether to keep practicing, and he knows how the abatement can make a difference.

In November 2002, his practice stopped seeing new patients. At the time, Gov.-elect Rendell announced his plan to ask the Legislature to allow high-risk specialists to forgo paying into the Mcare fund for 2003 and to permit other doctors to only pay 50% of their bills. With that promise and the fact that the state was already allowing doctors to defer their payments, Dr. Onofrey and his partners decided they could go back to work.

They continued to stay financially afloat after the state last year adopted a measure relieving some high-risk surgeons from their 2003 and 2004 Mcare assessments. The abatement saved Dr. Onofrey $40,000 to $50,000.

"That relief worked in keeping doctors in Pennsylvania," he said.

In addition to helping high-risk specialists, last year's measure gave family physicians in rural areas who do obstetrics a full abatement. Other physicians in Pennsylvania paid 50% of their Mcare bills for the two years.

The estimated $220 million in relief for physicians was made possible through a 25-cent tax on cigarettes. Physicians who accepted the abatement agreed to stay in Pennsylvania through this year or faced paying back 100% of the assistance.

Dr. Onofrey said he is happy that the House passed the new bill and hopes the Senate will follow suit. He also wants to see lawmakers enact long-term relief so physicians aren't constantly faced with the question of whether they'll be able to afford keeping their practices open.

"They haven't gotten to the heart of the matter," Dr. Onofrey said "We need caps [on noneconomic damages] or alternative dispute resolution."

Bipartisan vote

Pennsylvania's House passed the bill to extend the Mcare abatement by an overwhelming number: 192-4.

"The majority want this done and want to help us over the next couple of years," Dr. Lander said. "And there are a lot of people calling in wanting to know who voted against it."

There is some question whether the fact that this is an election year could have played into the vote, with some lawmakers voting for the abatement so they could tell their constituents they were doing something to help physicians, Dr. Lander said.

Nonetheless, doctors were pleased by the support the bill received. "It's fantastic to see it," Dr. Onofrey said. "Lawmakers realize there is a problem, and they are trying to help us."

Now the wait begins to see what will happen in the Senate. At press time, a date for the vote wasn't scheduled, but doctors are hopeful that the Senate will act before adjourning.

"We need it pretty badly," Dr. Lander said.

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External links

Pennsylvania Office of Mcare (link)

Pennsylvania Medical Society's Liability Reform Action Center (link)

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