HB 1428 -- Medical Malpractice Liability Insurance

Sponsor:  Harris (23)

This bill makes numerous changes to the laws regarding medical
malpractice liability.  In its main provisions, the bill:

(1)  Provides a tax credit up to $15,000 for tax years beginning
on or after January 1, 2005, for 15% of the increase in amounts
paid for medical malpractice insurance premiums from one policy
year to the next immediate policy year;

(2)  Exempts medical malpractice insurance from the operation of
Sections 379.017 and 379.316 - 379.361, RSMo;

(3)  Provides that insurers and self-insured health care
providers failing to timely report claim information pursuant to
Sections 383.100 - 383.125 will be subject to Section 374.215
penalties;

(4)  Requires the Department of Insurance to establish a method
of providing medical malpractice insurance to health care
providers if it finds that type of insurance is not reasonably
available in the voluntary market.  The department may establish
a competitive bidding process or any other reasonable method to
solicit bids from insurers;

(5)  Establishes standards and procedures for setting and
calculating rates pertaining to classes of medical malpractice
insurance;

(6)  Requires the ratio between the base rate of highest- and
lowest-rated specialties for medical malpractice policies written
in Missouri to be no more than 6-to-1;

(7)  Requires medical malpractice insurers, before using rates or
charging premiums in Missouri, to file and receive approval from
the department for a schedule of credits and debits used to
determine premiums;

(8)  Requires certain information to be filed with the department
by March 1 of each year, including:  closed claims; judgments,
payment, and severity of injury in connection with judgments;
rate changes during the previous five-year period; premiums and
losses by medical specialty; premiums and losses by experience of
insured; and investment performance of the insurer;

(9)  Requires the department by July 1, 2005, to develop and
establish an interactive Internet web site enabling health care
providers to obtain medical malpractice insurance quotes.
Insurers' rate changes must be integrated into the web site
within 10 days.  The site must provide contact information for
each of the insurers participating.  By December 1, 2005, the
director of the department must submit a report to the General
Assembly on the development, implementation, and effectiveness of
the web site;

(10)  Requires insurers to notify health care providers in
writing of renewal premium increases at least 90 days prior to
the date of renewal;

(11)  Establishes the Missouri Physicians Mutual Insurance
Company, a public corporation which will provide medical
malpractice insurance for its members.  A nine-member board of
directors, appointed by the Governor, will oversee the company;
and an administrator, hired by the board, will manage the
company.  Employees of the company will be immune from personal
liability for acts performed, or obligations entered into, when
done in good faith.  The board will have control over the
company's premium rates.  Any insurance producer licensed to sell
professional negligence insurance in the state may sell policies
for the company.  The administrator will formulate and implement
a program to reduce the amount of medical malpractice by
providing training seminars to physicians and their staffs.  The
board may deny insurance to physicians who refuse to attend the
training seminars.  The company will bear the cost of the
training.  The company may be capitalized by a loan of up to $10
million from the state's Physicians Mutual Insurance Company Loan
Fund, which is created in the bill.  Revenue bonds may also be
issued in an amount not to exceed a principal amount of $50
million;

(12)  Requires parties in tort actions based on improper health
care to make a good faith effort to engage in mediation with a
trained mediator and to submit a report of the results to the
court;

(13)  Deletes the "per occurrence" language in reference to caps
on noneconomic damages in order to overrule a Missouri Supreme
Court decision;

(14)  Establishes a procedure for health care provider defendants
to contest venue, stays most discovery during the pendency of the
venue contest, and awards costs, expenses, and reasonable
attorney fees to the prevailing party;

(15)  Requires that health care providers executing the expert
affidavit to have education, training, and experience in a like
area as the defendant health care provider or a logical extension
of the field and to be actively engaged in the practice of
medicine or retired within five years of the date of the
affidavit.  The affidavit is subject to an in-camera review by
the court upon motion of a party;

(16)  Prohibits statements, writings, or benevolent gestures
expressing sympathy from being admissible as evidence of an
admission of liability in a civil action.  Statements of fault
will be admissible; and

(17)  Authorizes the filing of a "miscellaneous" case for the
purpose of securing copies of health care records, details what
the petition should and should not contain, and provides that
filing a miscellaneous case tolls the statute of limitations for
medical malpractice for 120 days.

The bill contains an emergency clause.

Missouri House of Representatives
92nd General Assembly, 2nd Regular Session
Last Updated September 23, 2004 at 11:15 am