Senate Majority Leader Bill Frist Indicates Possibility of Compromise on Medical Malpractice Legislation
Senate Majority Leader Bill Frist (R-Tenn.) on Tuesday "signaled a new willingness to compromise" on stalled medical malpractice legislation and said he would consider reforms beyond caps on noneconomic damages, CongressDaily reports (Heil, CongressDaily, 3/16). Speaking to a group of obstetricians and gynecologists in a press conference, Frist -- a physician by training -- said he supports a $250,000 cap on noneconomic damages in malpractice cases, but he added that he is willing to consider other ideas and is seeking to start negotiations, CQ HealthBeat reports.
Frist said he is aiming to enact a "comprehensive" measure that could possibly include some insurance industry reforms that have been proposed by Democrats (CQ HealthBeat , 3/15). Frist said he could consider measures to modify "joint and several liability" in lawsuits, place "reasonable limits" on attorneys' fees and possibly raise the proposed cap on noneconomic damages.
While Frist did not detail possible changes to insurance laws, he said he would consider "something that would adjust or modify or send signals to the insurance industry." He added, "We will consider all kinds of options. Just come to the table" (CongressDaily, 3/16). Earlier on Tuesday, Frist noted, "I can't win on medical malpractice today. I only need three or four Democrats to come to the table" (Heil, CongressDaily, 3/15).
In addition, Sen. Rick Santorum (R-Pa.), who has criticized Democrats' positions on malpractice reform, told doctors at the press conference, "We've got to put the politics aside" (CQ HealthBeat , 3/15).
However, according to CongressDaily, other Republicans on Tuesday seemed "less conciliatory" on the issue of malpractice reform. "Let's see what the votes are," Sen. John Thune (R-S.D.) said, adding, "Let's see if (Democrats) are comfortable voting against their own OB/GYNs" (CongressDaily, 3/16).
HHS Secretary Mike Leavitt on Tuesday told the American Medical Association during a meeting in Washington, D.C., that CMS is considering administrative options to enact malpractice changes, CongressDaily reports.
Leavitt said he is "optimistic" about an HHS pilot program that would allow a patient and physician in a malpractice claim to submit to a third-party administrator confidential amounts they think should be in a settlement. If the amounts are similar or close, the administrator then could broker an agreement (CongressDaily, 3/15). Former HHS Secretary Tommy Thompson announced the program -- called "Early Offers" -- last fall (CQ HealthBeat , 3/15).
"That's just one option to take the gamesmanship out of the system," Leavitt said, adding that other administrative options could include using "risk-management" techniques and adopting new methods to prevent medical errors from occurring.
However, Leavitt and CMS Administrator Mark McClellan both noted that Congress still would need to pass a measure to correct flaws in the system. "We're working on limited administrative ideas that may address some problems in the interim," McClellan said, adding, "But these are limited steps, and what we really need is permanent reform" (CongressDaily, 3/15).
NPR's "All Things Considered" on Tuesday reported on Leavitt's statements. The segment includes comments from Leavitt; Donald Palmisano, former president of AMA; Todd Smith, president of the Association of Trial Lawyers of America; and Doug Wojcieszak, founder of the Sorry Works! Coalition (Rovner, "All Things Considered," NPR, 3/15). The complete segment is available online in RealPlayer.
McClellan on Tuesday also "addressed AMA members' concerns about Medicare payment cuts [that] are scheduled to begin next January," CQ HealthBeat reports. McClellan said CMS is considering an AMA proposal on how to change the Medicare payment formula, noting that doctors are the "critical piece" in providing care to Medicare patients.
Frist also noted that Congress would address the issue this year but said it was "too early to know" whether lawmakers will pass a one-year or multiyear alteration to the payment system.
In addition, Bush administration officials and lawmakers on Tuesday indicated to AMA that a "pay-for-performance" initiative linking Medicare payments with quality of care would soon be proposed, as well as a measure that would mandate audits on Medicare payments.
Separately, Rep. Nancy Johnson (R-Conn.) wrote in a letter to her House colleagues that "e-mails, phone calls and other new forms of communications and health care delivery must be integrated into the [Medicare] payment system to help avoid medical care in costlier settings, such as nursing homes, hospitals and emergency rooms." She added in her letter, "The challenge is real in a tight budget cycle but to fail will erode seniors' access to the physician of their choice" (CQ HealthBeat, 3/15).