Friday, May 10, 2002 | 11:14 a.m.
The Legislative Subcommittee to Study Medical Malpractice will meet Monday at 9:30 a.m. at the Sawyer State Office Building, 555 E. Washington Ave., Room 4401. The meeting will be simulcast in Carson City.
Gov. Kenny Guinn would love to jump right into the middle of the state's medical malpractice crisis, but he admitted Thursday he has little power to intervene in what is largely a private enterprise problem.
And, with the Legislature not in session, Guinn is also struggling to determine what he can do to increase reimbursements to doctors, cap their liability and change a state law regarding doctor licensing.
"I will exercise every ounce of emergency power I have," Guinn said Thursday.
Guinn has several ideas to try to solve the medical malpractice issue, but the question is what authority Guinn has under state law.
The attorney general's office is researching what Guinn can do under the Emergency Powers Act, but the office has told Guinn they might not know until late today or even Monday what options he has. Representatives of the attorney general's office and Attorney General Frankie Sue Del Papa did not return phone calls.
Guinn's statements -- including a suggestion that he will convene a special section of the Legislature if his powers are too limited -- are playing uneasily to some lawmakers.
Several state legislators interviewed by the Sun said they are quietly eyeing the governor's office, in part to see what Guinn offers as a temporary solution, but also because they are concerned about whether Guinn is trying to "skirt the Legislature" -- a fear one lawmaker expressed anonymously.
Among the powers Guinn would like to have is the ability to contract with area obstetricians -- perhaps offering them state employment for a nominal $1 a year. It's unclear if the law would let him do that.
That proposal would be similar to the $1 contract Guinn signed when he was asked to serve as president of UNLV. The $1 was a nominal fee he accepted to technically be classified a state employee who was eligible for liability protection, he added.
The medical malpractice insurance crisis has been driven by insurance companies who have pulled out of the state, forcing up insurance premiums. Insurance companies say Nevada is a difficult place to operate in because there is no cap on damages awarded in medical malpractice cases.
Under Guinn's plan, doctors would be treated as state employees who are protected under the law by a cap of $50,000 on malpractice claims.
A source familiar with the governor's talks this week with insurance division representatives and other key staff said Guinn particularly wants to do something about the reimbursements doctors get for treating patients in state-administered Medicaid and the Nevada Check-Up program.
During a speech to a meeting of the group Working in Communications on Thursday, Guinn told the story of how his personal physician's reimbursement dipped significantly when the governor's health insurance changed.
Guinn said he was insured through Southwest Gas Corp.'s coverage until he turned 65 last August. At that point, Guinn said he had to switch to Social Security.
When Guinn was covered under Southwest Gas his doctor got a $29 reimbursement for drawing blood to do a cholesterol check. Now that Guinn has Medicare, his doctor received $3 for the same procedure.
What's more, Guinn said, he was sent a letter asking him to verify that the bloodwork was done and that his doctor isn't committing Medicare fraud.
Guinn said he understands he has no power to ask private insurers to increase their reimbursement rates. However, he said he would like to know if the state could allow doctors to increase the rates they charge patients.
"You cannot go out and tell an insurance company what their rates are going to be," Guinn said. "I would like to be able to allow doctors to pass some of the increase on to their patients, whether it's $5 or $10, it would help."
Guinn said he would also like to change a state law to allow reciprocal agreements with other states to ease the licensing process for qualified doctors who wish to come to Nevada but don't technically meet the state's requirements.
"I'm not the lawyer but I sure would like to overrule the state law that says we don't have reciprocity," Guinn said.
Doctors must have three years of residency -- now a standard practice -- to work in Nevada. But, Guinn cites the hypothetical example of an exceptional surgeon who got his degree from UCLA 20 years ago when two years of residency was standard.
"If he leaves California and comes here, we don't have reciprocity and he would have to go through additional training," Guinn said. "That holds back some of the doctors who want to come here."
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