Maryland Seeks Funding for Med-Mal Plan

Democratic legislative leaders worked late last week to revive a stalled attempt to do something about the 33 percent increase in medical malpractice insurance premiums that some Maryland doctors say threatens to drive them out of business.

Doctors from across the state, especially obstetricians and hospital emergency room surgeons, have warned at hearings and meetings in Annapolis over the last year that they can’t afford the higher premiums and that many will have to limit or shut down their practices.

“What we’re trying to do is guarantee no rate increases to doctors whatsoever,” Senate President Thomas V. Mike Miller, said after a meeting Thursday with House Speaker Michael Busch. “We are also trying to increase the reimbursement rates for doctors who serve Medicaid patients.”

Miller and Gov. Robert Ehrlich attempted to arrange a meeting Thursday, but their schedules did not mesh, Shareese DeLeaver, a spokeswoman for the governor said. Miller planned to be out of town Friday, so DeLeaver said the two men will try to get together this week.

Asked about the possibility of a special session, Ehrlich said, “I will answer that question once I have a discussion with the president of the Senate.” Miller and Busch said they believe a special session is possible, but that it has to come soon.

Ehrlich submitted a bill to legislative leaders 10 days ago and said he would arrange a quick meeting with the speaker and president to discuss his plan. But Busch said there have been no further discussion, even at the staff level, since then.

The speaker said there must be two parts to any meaningful settlement – a temporary fund to maintain premiums at 2004 levels and a long-term solution that would include higher reimbursements for doctors and limits on malpractice lawsuits.

“Everyone has to come to a realization there is a crisis out there,” the speaker said. “The further you let it go, not only are you going to lose docs, no new doctors are coming into the system.”

Busch and Miller have pushed for a “stop loss” fund that would solve the immediate problem by holding premiums at the 2004 level and reimbursing insurance companies if premiums aren’t enough to pay malpractice claims.

Ehrlich included the stop loss fund in the bill he offered last week, but the Democratic leaders were unhappy that he did not provide a funding source. They favor requiring health maintenance organizations to pay the same 2 percent tax on premiums paid by other health insurance companies and using that money for health care.

Ehrlich has balked at any new fees or taxes. His bill provided that the money for the stop loss fund would come out of the regular general fund budget.

That idea drew criticism from Miller, who said money should not be taken out of the general fund at a time when the state is not spending the money it should on public education and is asking state employees and retirees to pay more of their health care costs.

“Under no circumstances can our general funds be allocated or used to help fund lifestyles for wealthy doctors and wealthy lawyers,” Miller said.

There is broad agreement in Annapolis that a crisis exists in the medical profession, that availability of health care is at risk and that doctors and hospitals are being squeezed between lower reimbursements for the services they provide and higher malpractice premiums.

But there is no consensus on why premiums are increasing and how much, if at all, money paid to settle lawsuits is contributing to the premium increases.

Miller and some other key Senate leaders have been reluctant to restrict medical malpractice lawsuits. But Busch said creation of a stop loss fund to deal with the immediate crisis can’t be accomplished unless the legislature also puts limits on lawsuits and does something about low reimbursement rates for doctors.

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