HARRISBURG -- Medical malpractice rates for many doctors will go up Jan. 1, and the state is so concerned about the ramifications that it is now surveying doctors to find out what they plan to do when the new year starts.
"Only now as they seek malpractice insurance coverage are physicians, hospitals and other health-care providers gaining a clearer picture of the malpractice bills they will face on Jan. 1," Gov. Mark Schweiker said in statement yesterday.
The state wants to know how many, if any, doctors plan to leave the state because of insurance rates, and where those who remain will obtain their state-mandated malpractice insurance policies.
"This information will give the administration the most up-to-date data available as we continue to focus on finding short-term solutions that will keep our doctors in Pennsylvania and preserve our world-class health-care system," Schweiker said.
Doctors will be asked to fill out a survey for the state over the Internet, while state officials will call all the hospitals to find out what insurance premium increases will mean to those organizations. Some hospitals already have closed trauma centers, saying premiums are too high to keep them open.
The problem of high insurance premiums has been building over the past two years, and state officials fear that a full-blown crisis may hit as of the first of the year, which is when many private physicians renew their contracts with hospitals and when their new insurance policies kick in.
Earlier this year, the Legislature passed some measures that lawmakers hope will provide some long-term fixes.
The most important change was to limit the payment of jury awards to the percentage of fault attributed by a jury to a doctor or hospital. In the past, winning a lawsuit guaranteed receiving the full jury award, regardless of who was deemed most responsible.
Those that were found responsible paid up, and if someone couldn't afford it, the rest paid that share.
Now, payment depends on if the person or company found most responsible has the money to pay the jury award.
Also, the new law requires medical malpractice lawsuits to be filed within seven years of the mistake. In the past, state law mandated that lawsuits be filed within two years of discovering the medical malpractice. The new deadline is designed to reduce the number of medical lawsuits.
Jury verdicts can now be paid over time instead of in lump sums, and judges now have the right to lower jury awards if they would force a doctor or hospital out of business.
Also, doctors are now allowed to carry smaller malpractice insurance policies, down from $1.2 million to $1 million.
After doctors barraged lawmakers for months about complaints about their insurance premiums, lawmakers decided to funnel $40 million that is collected by the state in traffic fines each year to doctors to help pay for their insurance.
Last month, the state decided to reduce premiums by 15 percent for doctors who can't get insurance elsewhere and must go through the state's Joint Underwriting Association.
Still seeing insurance rates going up and insurance companies refusing to renew policies, state Insurance Commissioner M. Diane Koken on Monday approved two new medical malpractice insurance entities to open for business in the state.
"These two new entities are part of a growing list of companies that are organizing to offer medical providers more options in a very tight medical malpractice marketplace," Koken said.
The latest organizations to be allowed to offer malpractice insurance are privately run consortiums put together by health-care operations.
They are Pennsylvania Health Providers Reciprocal Exchange and United Central PA Reciprocal Risk Retention Group. Both are based in Harrisburg.
"The upswing is that it provides options in the marketplace," said Charles Moran, spokesman for the Pennsylvania Medical Society. "On the downside, it is something doctors aren't used to ... and it carries risks. There is no guarantee these operations will stay in business, and if not there could be losses to physicians who subscribe to them."
The doctors' lobby blames large jury awards as the cause of insurance premium increases. Lawyers say the number of malpractice lawsuits has dropped 25 percent in the last eight years, and they blame insurance companies for raising malpractice premiums to make up for bad investments in the stock market over the past few years.
In the past three years, nine insurance companies have stopped writing medical malpractice premiums in the state, and Moran said the number of doctors who have had no choice but to use the state's Joint Underwriting Association as a last resort has increased.
In fact, 1,500 doctors in the state have policies through the association, a sharp increase from several years ago.
Another 160 doctors submitted applications this month for association insurance, and an additional 600 doctors have applied for the coverage as of Jan. 1, Moran said.
Surveying doctors on their plans as of the new year makes sense, and is a sign that the state continues to try to help the situation, Moran said.
"The problem is the rates are going up now and we need help now," Moran said. "The results of the survey certainly will be interesting. I'm not sure it's very scientific."
John M.R. Bull can be reached at jbull@post-gazette.com or 1-717-787-4254.
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