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Louisiana Medical Malpractice An Overview 2010 HOD

Louisiana Medical Malpractice An Overview 2010 HOD. Vince Culotta Jr. MD. Before Act 817. No limits Ad damnum clause Crisis of availability 1974 constitutional convention Sensational journalism Trial by press Reputations ruined. Act 817. No ad damnum clause Pre-trial Review Panels

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Louisiana Medical Malpractice An Overview 2010 HOD

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  1. Louisiana Medical Malpractice An Overview2010 HOD Vince Culotta Jr. MD

  2. Before Act 817 • No limits • Ad damnum clause • Crisis of availability • 1974 constitutional convention • Sensational journalism • Trial by press • Reputations ruined

  3. Act 817 • No ad damnum clause • Pre-trial Review Panels • Limited liability to $500,000 total • Personal limit of liability to $100,000 • Established PCF to pay claims in excess of $100,000 and receive complaints and determine qualifications

  4. Evolution of the ACT • Allowed settlement less than $100,000 to establish liability & PCF hands OFF • Roemer commission established unlimited payments for future medicals. • PCF oversight board. • Actuarial requirements applicable to PCF • Thirty percent requirement • 250 legislative challenges to act • Filing fees & Modified loser pay rules

  5. Forces affecting ACT 817 • Court decisions in progress • Taylor • Arrington • Olivier • Insurance commissioner • Rapid rise in the rate of increase • Concern for the unfunded liability • Desire to privatize • Legislation • Trail Bar • REP. John Bel Edwards • Attempts at compromise

  6. Court Decisions • Taylor & Arrington case • Olivier case • Texas Act • Constitutional concerns by many • Work group of the interested

  7. Louisiana Constitution ‘74 • §22. Access to Courts • Section 22. All courts shall be open, and every person shall have an adequate remedy by due process of law and justice, administered without denial, partiality, or unreasonable delay, for injury to him in his person, property, reputation, or other rights.

  8. Insurance commissioner • Afraid of another Citizens • Unfunded liability (400mil) • 530 mil in bank • Wants to close the UFL in 5 – 7 years • 20% increase for 5-7 years • DOI is suing the PCF • Legislative battle is looming

  9. La RS 40:1299.44 • (6)(a)  At all times the fund shall be maintained so as to provide a surplus of thirty percent of the annual surcharge premiums, reserves established for individual claims, reserves established for incurred but not reported claims, and expenses. • (b)  No reduction in the surcharge shall be made unless such surplus is available in the fund

  10. The PCF • Closing more claims than opening • Interest is a problem • No Knowledge of claim until underlying coverage is resolved • Unfunded liability calculated to be 400 MIL • Based on average with little facts • Reserves >30%

  11. La RS 40:1299.44 • (2)(b)  The surcharge shall be determined by the commissioner of insurance based upon actuarial principles and in accordance with an application for rates or rate changes, or both, filed by the Patient's Compensation Fund Oversight Board, established and authorized pursuant to Subsection D of this Section.

  12. Legislation • Working for one year with stakeholders • Trial bar gave nothing • Providers offered much • Expect cap bills and prepare to be involved • The LSMS has worked in good faith

  13. LSMS Actions • Ad hoc committee • Member of the work group • Authorization for COM and underlying coverage increase • Monitoring and working to represent all MDs insured, self insured and hospital based reflecting the membership

  14. 2008 Attempts at change by Coalition • SB509/SB70 Definitions of malpractice • SB652 PCF adjustments • HB658/SB217 willful & wanton • SB664/HB881 C.O.M. • SB302?HB555 Claims made/ tail • SB661 250000 non-economic cap, 250,000 underlying, PCF layer 500,000-750000. Future meds 2,000,000 • HB826/SB320 constitution amendment for caps

  15. What has to be done?? • Participate • Follow the session • Calls • Emails • Contacts • Will Medicine will be divided?

  16. The future • Change will happen! • Who drives the change? • What will we gain? • What will we lose? • Who will be the losers? • Will there be caps? • What will be capped?

  17. Information • www.legis.state.la.us • www.lsms.org • www.lammico.com • www.lapcf.state.la.us • van@culotta.net

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