Georgia enacts tort reform package

Three years of fighting for tort reform has finally borne fruit for Georgia doctors, who celebrated the passage last month of legislation that sets a $350,000 cap on noneconomic damages in medical liability lawsuits.

Georgia Gov. Sonny Perdue signed the bill into law Feb. 16 -- a move physicians say will help create better access for patients and help improve care. The state is one of 20 the AMA has declared to be in crisis because of rising medical liability insurance premiums. While some physicians were retiring early, others were forced to discontinue high-risk procedures or leave the state, leaving some areas of Georgia with very little coverage.

"I would like to tell doctors to come back to Georgia, or to come to Georgia," said Medical Assn. of Georgia President John Antalis, MD, a family physician and geriatrician from Dalton. "With this, we now have the ability to hold down liability costs."

This is the first time a tort reform bill has passed in Georgia with a noneconomic damages cap, Dr. Antalis said. The legislation initially passed through Georgia's Senate with a $250,000 limit, but an amendment was added in the House that changed the cap to $350,000.

MAG was willing to accept the higher cap because "for physicians, it will still provide meaningful relief," said David Cook, the association's executive director.

The state's primary medical liability insurance provider, MAG Mutual Insurance Co., has pledged to roll back premiums now that noneconomic damages will be capped, Cook said. The physician-owned company is independent of the medical association.

The law has several other components, such as allowing physicians to apologize without having it used against them in court and tightening requirements for expert testimony by adopting federal rules.

The measure also protects emergency physicians, saying no doctor in an emergency setting will be held liable unless there is gross negligence.

Several patient safety provisions are included in the law. For example, medical liability insurers must report all judgments and settlements against physicians -- a change from current law, which requires reporting of cases in excess of $10,000. In addition, the measure requires a medical board investigation of any physician who has paid three liability claims in 10 years.

Georgia physicians were joined by business groups and hospitals in advocating for the legislation. Consumer watch groups and trial attorneys opposed it.

Opponents disappointed

Allison Wall, executive director of the consumer group Georgia Watch, called the law's patient safety measures "mere window dressing" and the extra $100,000 added to the damages cap during the House session "a pittance."

"No one wins except for insurance companies," she said. "When you want reductions in insurance costs, you need better regulation of the insurance industry."

Georgia Watch has advocated an insurance reform package that includes repealing the antitrust exemption for companies writing policies in the state, requiring insurance companies to justify "significant" rate hikes to customers and giving the insurance commissioner more oversight power in reviewing rate increase requests. Physicians should not be paying higher premiums because of the mistakes of others, but there should be stronger action taken against repeatedly negligent doctors, Wall said.

A representative from the Georgia Trial Lawyers Assn. did not return calls for comment.

Tort reform was an elusive target over the last few years, as physician groups were unable to drum up enough support for a cap on noneconomic damages. Doctors instead focused on changing the composition of the Legislature, and saw 12 of the 13 candidates MAG supported last fall win their races, Dr. Antalis said.

"Our plan involved a focus on the issues, like the [physician] shortage we had, especially in several specialties," Dr. Antalis said. "We talked about the need to do something."