Freeze due on malpractice cost

By PATRICIA NORRIS
http://www.masslive.com

Springfield, MA-Medical Professional Mutual Insurance Co., the state’s largest insurer of physicians, surgeons, dentists and nurse midwives, will not increase malpractice insurance rates this year.

High malpractice insurance rates have irked practicing physicians, particularly specialists such as obstetricians, neurosurgeons and others considered high risk.

High rates are blamed for physician shortages and obstetrician-gynecologists opting out of delivering babies.

Insurers blame cost increases on the rising number of medical malpractice lawsuits and large jury awards levied against doctors.

But claims that the medical malpractice system is awash in frivolous lawsuits are overblown, according to a report last year in New England Journal of Medicine.

The report found that people with legitimate claims often don’t get justice – a problem researchers attribute in part to the expense of attorneys’ fees and court costs.

Under ProMutual’s 2007 rates, doctors in obstetrics, orthopedics and anesthesiology could see as much as 10-percent reductions in their premiums.

“We are seeing some moderation to the claims being filed,” said Richard W. Brewer, president and chief executive officer of ProMutual, about why the company held rates steady.

Claims filed against doctors dropped about 2 percent this past year, Brewer said. He did not have exact figures.

“There is a cyclical nature to this business, and we also think things like patient safety initiatives, including our own risk management programs, are paying dividends,” he said.

ProMutual increased rates 5 percent last year, but did not impose any increase in 2005, he said.

Doctors, depending on their specialty, can pay anywhere from $10,000 to $100,000 a year for insurance.

Dr. Kenneth R. Peelle, president of the Massachusetts Medical Society, was appreciative of the freeze. “We are very pleased they did not go up,” he said.

The new rates are subject to review by the Massachusetts Medical Society and the Massachusetts Division of Insurance.

If approved, they will apply to policies effective on or after July 1. Officials say the rates would affect more than 9,000 health care providers.

But Peelle said premiums are only part of the problem for physicians in Massachusetts.

“The fact remains that the medical liability system in Massachusetts is dysfunctional and needs major reform.

“Our premium levels are still among the highest in the nation and are a significant reason why health care costs in Massachusetts are high,” he said.

Medical liability reform continues to be one of the society’s major goals, Peelle said.

The organization has filed six reform bills, including a package to change the state’s professional liability system by addressing reporting requirements of insurers, board certification of expert witnesses, periodic payments of awards, adjustment of prejudgment interest rates and other issues.

The society also is fighting to make medical professionals’ statements of regret, apology and concern inadmissible as evidence in judicial or administrative proceedings.

Meanwhile, Dr. Claudia L. Koppelman, a Holyoke internist, has seen her insurance go from $3,000 a year to $10,000 in the last decade, while her income has gone down 30 percent, she said.

Such premiums, coupled with the fact that health insurance companies do not reimburse the full cost of delivering care, has become detrimental to health care, she said.

“It is a pretty in-depth problem,” she said.

“I no longer have a nurse working for me, because I can’t afford to keep my practice going,” she said.

Koppelman, who has a ProMutual plan, said she would not switch to the state’s other insurer, Connecticut General, because ProMutual offers legal assistance in the event a physician is asked to come before the state’s medical board.

Peelle believes Connecticut General offers slightly lower rates than ProMutual in some instances, which may have affected ProMutual’s decision to hold the line on rates.

“Competition may have something to do with it,” he said.
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