Senator calls for subsidies for state doctors

Monday, Dec. 9, 2002 | 11:14 a.m.

RENO -- The state Board of Medical Examiners has built up a $3.35 million surplus and wants to give the estimated 5,000 Nevada doctors a $1 million dividend.

But state Sen. Ann O'Connell, R-Las Vegas, wants to use $2 million of that reserve to subsidize doctors hit with high medical malpractice insurance premium increases. She said she wants to keep physicians from leaving the state.

The medical examiners board voted unanimously Friday to reduce the biennial dues paid by physicians from $600 to $400. The bills go out in March and the payments are due by July. It also agreed to eliminate the $200 biennial fee charged for administering an application by a doctor to oversee physician assistants and advanced nurse practitioners.

"It's time to pay a dividend," said Dr. Paul Stewart of Las Vegas who serves as secretary-treasurer of the board.

Larry Lessly, executive director of the board that licenses and regulates physicians, has increased its surplus since it raised its biennial registration to $600 in 1996. He said the balance grew partly because of its investments but added, "We have not done anything risky."

The goal of the board, he said was to have enough money in reserve to allow it to operate for two years. He said that target was reached at the end of the last fiscal year. By reducing dues and eliminating the administrative fee, the reserve will shrink to $2.5 million by the end of the next biennium.

Lessly told the board that O'Connell has asked for a bill to tap into the reserve to relieve medical malpractice costs faced by physicians.

O'Connell said Sunday she wants to take $2 million from the reserve to set up a fund to help physicians who have difficulty in paying their rising medical malpractice insurance. At last count, she said 150 doctors have either left Nevada or quit their practice because of the malpractice crisis.

Her bill, O'Connell said, would require the physicians pay a one-time $200 to augment the $2 million for subsidies for doctors "who have extreme difficulty" in paying the premiums.

The subsidy fund would expire in 2005. Under the O'Connell plan, the doctors would not get the suggested $200 in lower dues. But she said the plan would help physicians in Nevada.

How these competing plans will fare will be played out in the 2003 Legislature, which opens in February.

Dr. Rudy Manthei, the spokesman for Keep our Doctors in Nevada, a group that has a petition before the Legislature to revamp the medical malpractice law, said he supports the O'Connell plan. He said it was a "short-term solution" to allow other steps to be taken to solve the problem.

"We need the subsidy to protect doctors from the exorbitant premiums," Manthei said. If nothing is done, Nevada will continue to lose physicians. He said a lot of doctors will be renewing their insurance in the next six months and they will be hit with the big increases.

The money being talked about, he said, was all paid by physicians. "We are subsidizing our own," Manthei said.

And he said the insurance industry "must step up to the plate" to help solve this crisis. "They have not come to the table," he said, other than to talk about leaving the state.

Gov. Kenny Guinn said it was up to the examiners board to do what they want to do with the money, since it was all paid by the doctors. "The board has to be judicious," he said.

He wondered if those physicians who have practiced a long time will get a bigger rebate than the newly licensed doctors. The medical board is giving everybody the same $200 rebate.

The governor didn't have a comment on O'Connell plan, saying it would have to go through the Legislature.

O'Connell said the reserve in the examiners board "seems excessive." She said a review of the minutes of board meetings showed members talking about hiding the money and possibly constructing its own building.

The medical examiners board, she said, is supposed to exist to help the doctors. But during this malpractice problem, "They have not stepped up to the plate to help our doctors."

Lessly referred to the law that says the duty of the board is to assure the competency of physicians and to license and regulate the profession. The board, he said does not have the responsibility in the law to help doctors pay their insurance premiums.

Lessly said, "We should do something we (the board) deem appropriate with our funds." The board will dip into its reserve for $600,000 in the first year of the next biennium starting in July and than for $800,000 to $900,000 in the second year.

Lessly said this will mean 20 percent of the doctors will get a 50 percent reduction when they pay their dues this spring, which are due July 1. And 80 percent will receive a one-third cut.

There will not be any lowering of dues paid by the 798 respiratory therapists or the 267 physician assistants that are both regulated by the board.

Stewart said a healthy reserve is needed to take care upgrading the board's computer system and to handle defense of lawsuits against the board. "Everything we do ends up in the judiciary," he said. Lessly said there is one suit involving the board and some members that has been in the court system 10 years.

Board President Dr. Cheryl Hug-English of Reno said, "We have reached our goal and now it is time to give the money back."

Lessly said he would submit his proposed budget in March for about $2.1 million next fiscal year and $2.3 million the following year.