GOP bill would create health care tribunals

Washington -- New House legislation aims to curb the overuse of health care by establishing clinical best practices for physicians and creating health care tribunals to hear medical liability cases.

"The practice of defensive medicine adds billions of dollars of unnecessary costs to our health care system and diverts doctors' focus away from delivering quality care," Rep. Tom Price, MD, (R, Ga.) said in a statement after introducing the legislation on June 24.

The bill would use a three-pronged approach to end overutilization of tests and other unnecessary care while respecting the rights of patients and doctors to determine the best course of treatment, he said. The legislation would:

• Protect doctors and other health professionals from liability if they practice medicine consistent with best practices developed by physician specialty and quality organizations, and then approved by the Health and Human Services secretary.
• Provide grants to states to create administrative health care tribunals. The tribunals would hear cases after another panel of three to seven experts reviews evidence. Judges with health care expertise would lead the tribunals.
• Preserve the ability of a plaintiff to file a claim with a state court after administrative remedies are exhausted.

Performance guidelines could reduce the practice of defensive medicine, said George Dikeou, an attorney with the Denver liability insurer COPIC who has written about medical liability issues. Tribunals alone would not end defensive medicine, but the health courts could resolve some disputes more quickly than civil courts, he said.

"That's clearly an advantage if they are efficient and work well," Dikeou said.

Some states have tribunals and other health panels. For instance, the Massachusetts Medical Malpractice Tribunal operates with a three-person panel consisting of a judge, attorney and medical expert. The tribunal hears only from the plaintiff when in session and decides whether there is enough evidence to bring a case before a jury.

The Massachusetts court is good at stopping frivolous cases from moving forward, said Marylou Foley, a registered nurse and claims manager with the medical liability insurer ProMutual Group in Boston. Tribunals under Dr. Price's bill would have the benefit of more experts looking at a case, she said.

The American Medical Association has supported liability reform efforts and is open to alternatives that would bring more fairness and stability to the medical liability system, said AMA President Peter W. Carmel, MD.

"Proposals like the one advanced by Dr. Price are worth considering, and we look forward to working with him, other members of Congress and the administration to advance common-sense reforms that improve the system for patients and physicians," Dr. Carmel said.

Dr. Price's Health Care OverUse Reform Today Act, or HealthCOURT Act, has been referred to the House Energy and Commerce Committee.