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April 24, 2014

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Doctors get boost in Senate

CARSON CITY -- The Senate Tuesday approved bills and amendments that would give doctors added protection in medical malpractice suits and in proposed insurance rate increases. The Senate also approved a measure that would make it harder to discipline errant physicians.

Medical malpractice has been one of the major issues since the beginning of this legislative session because the state's shortage of doctors has been blamed on rising insurance costs.

Despite opposition from Democrats, Republicans pushed through Senate Bill 97, which imposes a firm $350,000 cap on damages for pain and suffering in a malpractice suit.

The bill, which goes to the Assembly, eliminates from the present law the ability to exceed the $350,000 cap if there is gross malpractice by a doctor or if there are exceptional circumstances in the case that merit a higher award.

It also imposes a limit on fees winning attorneys can collect in malpractice judgments.

Sen. Terry Care, D-Las Vegas, who spearheaded the opposition, predicted SB97 would be "decimated" in the Assembly where members are more concerned about patient rights.

If the bill is amended in the Assembly, it would return to the Senate for agreement or disagreement. If there is no consensus, the legislation would go to a conference committee to work out the differences.

SB97 is a carbon copy of an initiative petition started by doctors in Southern Nevada to enact a medical malpractice law similar to the one in California. The doctors gathered more than 90,000 signatures and the petition will appear on the November 2004 ballot.

The bill eliminates many of the provisions enacted by a special session of the Legislature in July 2003.

Sen. Sandra Tiffany, R-Henderson, said the California law is a "proven solution" that will result in stable insurance rates. She said it will bring competition back to the insurance market in Nevada with companies not having the ability to predict losses.

Sen. Dennis Nolan, R-Las Vegas, said he did not like SB97 in its present form but he also called it "meaningful legislation" that will allow malpractice reform to begin now instead of waiting until November 2004.

Proponents of SB97 say it will help stem the exodus of doctors from the state and stabilize the insurance premiums.

Care, in arguing against the bill, said the 2003 law has been in effect only since last October and hasn't had a chance to work.

Care, an attorney who does not take malpractice cases, was critical of the section of the bill in which the fees of lawyers are capped. Opponents of the bill said the fees of lawyers are not capped in any other cases unless it might involve public funds. And they said the fees attorneys receive do not impact the insurance rates.

Senate Minority Leader Dina Titus, D-Las Vegas, also urged the Senate to allow the 2003 law to work and she added that what may be good for California doesn't work in Nevada.

Sen. Mike Schneider, D-Las Vegas, joined the Republicans in voting for the bill. Sen. Mark Amodei, R-Carson City, was on the losing side with Democrats.

There was no opposition to another bill intended to assist physicians. The vote was 21-0 to approve Senate Bill 122. It aims to help doctors fight insurance companies that want to raise malpractice rates.

The bill allows doctors to intervene when an insurance company files for a rate increase with state Insurance Commissioner Alice Molasky-Arman.

SB122, by Titus, would prohibit an insurance company from including losses on investments as part of the justification for a rate hike. Titus said the bill is intended to prevent such things as a loss on Enron stock from being used to ask for a higher rate on malpractice insurance.

The Senate, by voice vote, also adopted amendments to Senate Bill 250 that would require the state Board of Medical Examiners to find "clear and convincing evidence" before it can discipline a doctor. At present the standard is a preponderance of evidence, which is a lesser standard.

The bill, which was referred to the Senate Finance Committee, also requires five of the six members on the judging panel of the medical examiners board to find the defendant guilty. At present only four members are required for an affirmative vote.

The bill also would prohibit state boards from sending private letters of reprimand to those who are regulated. The letters would have to be public.

SB250 also would set up a fund, paid for by taxpayers, to subsidize the malpractice insurance premiums of doctors. Sens. Randolph Townsend, R-Reno, and Ann O'Connell, R-Las Vegas, originally wanted to take millions of dollars out of the reserve fund of the medical examiners board to finance the subsidy.

The examiners board said it didn't have the money in its reserve to pay for the subsidy. So the bill is going to the finance committee to find the money. The subsidy would not exceed $30,000 for a doctor.

The bill requires the medical examiners board to move its headquarters to Las Vegas from Reno when its lease expires in 2007. It also makes it mandatory that the medical examiners board hire an independent auditor to look at its performance in licensing and disciplining physicians.

The examiners board, under SB250, would also be able to waive the requirement in certain circumstances that a physician have three years of progressive education after graduating from medical school before being licensed.

The bill said if the governor determines there are "critically unmet needs" in the number of specialists in the state, such as obstetricians, the board may grant a restricted license.

The physician would have to have completed at least one year of training as a resident, have a minimum of five years practical medical experience and meet all the other requirements.

Townsend and O'Connell initially wanted to force the board to eliminate its private lawyer that acts as a prosecutor in discipline cases and instead make it use the state Attorney General's Office. But they deleted that section from the bill.

SB250 will probably remain in the Senate Finance Committee for weeks until a tax plan is developed to finance the budget for the coming two years.

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