Guinn proposes medical crisis solutions

Cy Ryan and Erin Neff

Tuesday, May 28, 2002 | 11:11 a.m.

CARSON CITY -- Gov. Kenny Guinn's administration is looking at cutting the medical malpractice premiums charged high-risk doctors who have entered the state's insurance program, a highly placed government official said today.

The official, who asked not to be identified, said one of the options that Guinn is considering is to significantly lower the rates paid by surgeons and obstetricians who enrolled in the Medical Liability Association of Nevada.

No final decision has been reached, and the official said it wasn't clear whether such a plan would require state subsidy.

The governor met last week with hospital chief executives, doctors, insurance providers, cabinet-level directors and senior staff to determine what his next move should be.

Greg Bortolin, Guinn's press secretary, said "everything is on the table" as the governor seeks to alleviate the malpractice crisis in which physicians have threatened to leave the state because of the high insurance rates.

Bortolin said today the governor and the state Insurance Division are examining the possibility of modifying the so-called "tail."

Doctors who entered the state system were required to pay their former company a premium to cover possible past acts of malpractice. Guinn had convinced the St. Paul Cos., which was the major insurer of doctors in Nevada, to allow the tail premium to be paid in installments over a three-year period.

St. Paul Cos. announced in December it would pull out of the medical malpractice business this year, sparking the insurance crisis.

The board of directors of the Medical Liability Association of Nevada, the state's insurance plan, agreed last week to provide tail coverage to physicians.

John Orr, deputy director of the state Insurance Commission, said the present emergency regulation setting up the state-operated system did not allow tail coverage. But Commissioner Alice Molasky-Arman is considering a change to permit the state system to cover past acts of the doctors.

Guinn plans to hold a press conference Wednesday to announce changes he decides on, Orr said. The governor was out of state this morning and could not be reached.

Guinn is reportedly committed to also addressing the reimbursement rates obstetricians receive from health insurance providers, and has said he favors allowing doctors to pass an additional $5 to $10 on to their patients for each visit.

"We're considering some things about payments," Bortolin said.

Three weeks ago Guinn said he was considering having doctors temporarily sign contracts to be state employees -- a move that would allow them to come under the $50,000 liability cap government employees have to protect from litigation.

He also said he had asked the Attorney General's Office to define what powers, if any, he could invoke as part of the state's Emergency Powers Act.

Guinn had suggested he wanted to repeal a state law governing doctor licensure to allow experienced doctors to transfer to Nevada without meeting the state's residency requirements. The governor argued veteran doctors might not have the three years of residency that is now required, because two years of residency used to be sufficient.

Orr said the state insurance system has received 206 applications from doctors as of last Tuesday. He said 59 of them have been "bound" or accepted for coverage. He said the system expected to accept the rest shortly.

Orr said their rates are now being computed and it will be up to the individual doctor whether to join the state system.