The Florida legislature last night passed a massive malpractice reform bill that includes a $500,000 cap on noneconomic damages for physicians in malpractice lawsuits.
The bill, expected to be signed by Gov. Jeb Bush within a few days, also includes provisions on expert witnesses, patient safety requirements and a provision for possible premium reductions by malpractice insurers.
The Florida Medical Association, which had insisted on a $250,000 cap, opposes the higher limit but welcomes many of the other provisions, according to FMA spokeswoman Lisette Gonzalez Mariner.
For example, she says the group welcomes the bill's lower $150,000 cap on noneconomic damages for emergency physicians and physicians who are on call at hospitals.
After months of legislative wrangling over a $250,000 cap, the newly passed bill is based on a compromise announced by Bush and legislative leaders last week.
The following highlights of the 170-page bill are based on a digest of the bill prepared by the FMA:
Cap on noneconomic damages: The bill establishes a $500,000 cap on noneconomic damages per claimant, regardless of the number of defendant physicians. But any one physician is responsible for no more than $500,000.
Cap for all doctors can be raised to $1 million: In cases involving wrongful death and permanent vegetative state, all claimants may recover a total of $1 million in noneconomic damages from all physicians. The higher limit also applies if the trial court finds that a manifest injustice would occur if the lower cap was imposed and the finder of fact finds a catastrophic injury has occurred.
Cap for hospitals: For hospitals and others in a "non-physician" category, noneconomic damages are limited to $750,000 per claimant, with a total for all claimants of $1.5 million.
Separate cap for emergency room: For emergency physicians and doctors on call, the cap is $150,000 per claimant and the total noneconomic damages recoverable by all claimants from all physicians is $300,000. For facilities, non-economic damages shall not exceed $750,000 per claimant and the total noneconomic damages recoverable by all claimants from all facilities is $1.5 million.
Mandatory mediation: All medical negligence suits must be mediated within 120 days after suit is filed. This also provides for the increased exchange of information during the pre-suit process.
Expert witnesses: The expert must be in the same or similar specialty as the defendant and must have been in the active practice of medicine in the last three years, involved in teaching, or in a clinical research program. The expert who signs the pre-suit affidavit must have the same qualifications as the expert who testifies at trial.
Limits to HMO liability: Because a physician is on an HMO panel does not make the HMO automatically liable for the negligence of the physician. Also, health insurers and HMOs will fall under the same cap as the healthcare provider
Malpractice insurer rate reductions: Malpractice insurers must file rates that reflect a rate reduction factor determined by the Florida Office of Insurance Regulation. Rates in effect on July 1 will be frozen until this new rate filing.
Self-insurance: A group of 10 or more physicians can form a commercial self-insurance fund.
Physicians' financial responsibility: If a physician fails to pay at least $100,000 (or $250,000 if the physician has hospital staff privileges) of a medical malpractice award within 30 days of the award, the Department of Health (DOH) must suspend that physician's license.
Patient safety training: College and university healthcare training programs must provide instruction in patient safety. Doctors must have training in misdiagnosed conditions as part of their current CME requirements.
Reporting adverse incidents: Hospitals and physicians must inform patients of an adverse incident, but notification is not considered an admission of liability.
Wider immunity for hospital medical staff: The act broadens immunity for hospitals and staff who take disciplinary actions against medical staff.