In his health reform address to a joint session of Congress, President Obama announced that he has directed the Secretary of Health and Human Services to begin work immediately to offer state demonstration grants on alternative medical liability reforms. The announcement follows months of dialogue with the president, senior White House officials, AMA leadership and advocacy staff, beginning immediately after the elections.
During a meeting in May with President Obama, AMA President J. James Rohack, MD, linked the cost of defensive medicine to desires to “bend the spending curve” and urged consideration of “safe harbors” for physicians adhering to best practice guidelines. In addition, the AMA has advocated funding for states to test health courts, early offer programs and certificates of merit to dispense with nonmeritorious claims.
This concept of state pilots to test alternatives has been previously advanced in legislation sponsored by Sen. Michael Enzi, R-Wyo., and Sen. Max Baucus, D-Mont. In July, the House Energy and Commerce Committee adopted an amendment to H.R. 3200 that provided state grants to test early offer and certificate-of-merit programs.
At the federal level, caps on noneconomic damages have created a challenge for the AMA and state medical societies. When Republicans held a majority in the Senate and an effort was made to secure Democratic support for caps on noneconomic damages, the discussion focused on a $500,000 cap with exceptions for certain cases. Some Republican senators also expressed support for exceptions to a noneconomic damages cap. The AMA has consistently opposed federal proposals that would undermine effective state laws such as those in California, Texas, Louisiana, Indiana, Kansas, Georgia and Mississippi.
The state pilot projects announced by President Obama will be administered by the Agency for Healthcare Research and Quality. The AMA will provide additional information on this initiative as soon as it is available.
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