Medical insurance debate reopened

Dan Kulin and Erin Neff

Tuesday, Dec. 3, 2002 | 11:23 a.m.

The Legislature will be forced to reopen the contentious medical malpractice debate when it convenes in February because of a doctor-backed petition that was qualified Monday by the Secretary of State.

The Legislature will either have to pass the petition or some form of it or put the petition on the 2004 ballot.

Lawmakers were divided by the petition that seeks to overturn a law passed this summer in a special legislative session.

Republicans, who support reforms similar to what the doctors argue, favor revisiting the law they say was a quick fix; Democrats say the types of reforms in the petition would be unconstitutional.

Gov. Kenny Guinn wants to wait to see how the reforms passed this summer play out.

The petition, circulated by a group named "Keep Our Doctors in Nevada," calls for changes to the law to limit the amount of money attorneys can receive for their fees in malpractice cases, and set a firm cap of $350,000 on how much a patient can recover for pain and suffering.

The law passed by the Legislature during a special session established a $350,000 limit for noneconomic damages, but in certain cases an injured patient could collect more.

Larry Matheis, executive director of the Nevada State Medical Association, said the petition would keep the issue alive.

"We know the legislation (that was passed) will take time to work," Matheis said. "If it works, we won't know for several years. But what if we're at 2004 and have lost 40 percent of the doctors in Clark County?"

Matheis said Clark County has lost 10 percent of its doctors since January.

The law was intended to help rein in judgments in medical malpractice lawsuits, which insurers cite as the reason for rising malpractice insurance premiums.

Those premiums, which have in some cases tripled in the last year, have forced many doctors from the state.

Guinn led the charge to reform the state's medical malpractice laws, calling a special session of the Legislature and asking representatives of the health care, legal and insurance industries to try to come to resolution.

Guinn's spokesman Greg Bortolin said the governor's position has not changed since the Legislature's special session in August produced a limited cap on so-called pain and suffering damages in jury awards.

"The bill was just implemented in October and the governor strongly believes that bill needs time to work," Bortolin said. "Stabilizing insurance rates takes a long time."

Bortolin also said the governor's office would defer to the Legislature to see how lawmakers handle the petition.

If the Legislature adopts the provisions of the petition and Guinn signs it, it becomes law. If not, the Secretary of State can place it on the 2004 general election ballot for voters to consider.

State Sen. Ann O'Connell, R-Las Vegas, said she thinks it is critical for the Legislature to revisit medical malpractice.

"We're talking about the need to raise taxes, but when you talk to the Nevada Development Authority, the top issue that businesses seeking to relocate here want to know about is the health care system.

"A lot centers around the health of the state," O'Connell said.

Assembly Minority Leader Lynn Hettrick, R-Gardnerville, said the Legislature's three-day "quick fix" in a special session this past summer was a good start.

"I believe we could have done a little more," Hettrick said. "I'm not sure we solved everything we need to solve."

But Assembly Speaker Richard Perkins, D-Henderson, said he is concerned that the petition goes "too far" and crosses the tenuous line lawmakers walked in the special session as they tried to balance health care needs with constitutional rights.

"The items specifically in the petition would create a situation where medical malpractice reform in Nevada becomes unconstitutional and the Supreme Court would throw it out," Perkins said.

Assembly Majority Leader Barbara Buckley, D-Las Vegas, agreed the petition would jeopardize the reform already enacted.

"If you begin to tinker with that you endanger the likelihood that it will be held constitutional," Buckley said.

Jim Wadhams, a Las Vegas attorney who is an insurance industry lobbyist, said the Legislature will probably give the changes passed during the special session more time to work.

If the changes the petition calls for are passed, those changes would be challenged in court, Wadhams said.

The problem in Nevada is that malpractice insurance premiums skyrocketed, in some cases going above $100,000 a year. That has made doctors look to health insurance companies to increase payments to make up the difference, Wadhams said.

Many insurance companies in Southern Nevada have increased payments to OB/GYNs in recent months in an effort to offset the increased cost of insurance.

"Some have done a wonderful thing," Dr. John Nowins, president of the Clark County OB/GYN Society, said. "But from most it's still not enough. That's why doctors are still leaving.

"It's only because of the crisis, the exodus of doctors that finally insurance companies have come to the plate and given increases."

A few medical insurance companies have significantly increased the amounts they reimburse OB/GYNs for services, but "most have given insignificant increases," Nowins said.

Physicians IPA -- a network of doctors who contract with PacifiCare of Nevada -- announced Monday they were increasing reimbursements to OB/GYNs, but Dr. Stanley Abramow, a member of the group, said the increases are "maybe a couple hundred dollars. Not enough to do anything," he said.

In November, Sierra Health Services, the state's largest managed-care insurer, also increased its reimbursement rates to OB/GYNs. But Nowins said the increase amounts to "just a couple hundred bucks" per patient.

"It's peanuts," Nowins said. "Insignificant."

Nowins said the proposed changes to the law in the petition are needed to lower the cost of malpractice insurance.

Sun reporters

Cy Ryan and Jean Reid Norman contributed to this story.