The Battle to Protect MICRA Presented by Lisa Maas Executive - - PowerPoint PPT Presentation

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The Battle to Protect MICRA

Presented by Lisa Maas Executive Director Californians Allied for Patient Protection September 16, 2014

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What is MICRA?

Photo courtesy of La Clinica de La Raza

• The Medical Injury Compensation Reform Act

(MICRA) is California’s landmark health care liability reform law signed by Governor Jerry Brown.

• MICRA’s reforms ensure that injured

patients receive fair compensation while preserving patients’ access to health care.

• MICRA keeps liability rates reasonable for

doctors, nurses, hospitals, clinics, and other medical staff to prevent further increases in the cost of health care.

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MICRA: The History

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• UNLIMITED economic damages for any and all past and future

medical costs.

• UNLIMITED economic damages for lost wages and lifetime

earning potential.

• UNLIMITED punitive damages for malicious or willful conduct.
• ADDITIONALLY, up to $250,000 for non-economic damages.
• LIMITS the amount of money a lawyer can take as payment for

representing an injured patient.

MICRA Provides

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MICRA Works

Photo courtesy of Eisner Pediatric & Family Medical Center Photo courtesy of Operation Access Photo courtesy of St. John’s Well Child & Family Center

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California vs. U.S. Premiums 1976‐2012

0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 7.0 7.5 8.0 8.5 9.0 9.5 10.0 10.5 11.0 11.5 12.0 12.5 13.0 76 78 80 82 84 86 88 90 92 94 96 98 '00 '02 '04 '06 '08 '10 '12

$ Billions

U.S. Premium + 746%* CA Premium + 241%

No Crisis in California

Source: NAIC Profitability By Line By State 1976-2012 (Medical Malpractice) Prepared by: NORCAL Mutual 2/6/14

*Includes California

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States Without Medical Liability Reform Suffer

California

(L.A./Orange Counties)

Illinois

(Cook/Madison/

• St. Clair Counties)

New York

(Nassau/Suffolk Counties)

OB/GYN

$71,248 $177,441 $184,802

General Surgery

$54,400 $118,909 $133,593

Internal Medicine

$15,415 $40,865 $35,733

Source: Medical Liability Monitor, 2013 professional liability rates

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Medical Liability Reforms Work

• Texas enacted medical liability reforms in 2003 and has since added more

than 14,000 in-state, active physicians. Additionally, 35 rural Texas counties have added at least one obstetrician, including 16 counties that previously had none; 46 counties that did not have an emergency medicine physician now do; 15 counties that did not have a cardiologist now do.

• New York does not have liability reforms. 19 counties are without
• bstetricians, 22 are without internal medicine specialists, and 15 do not have

surgical specialty doctors, according to the Center for Health Workforce Studies.

Photo courtesy of The Saban Free Clinic

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The mission of Californians Allied for Patient Protection (CAPP) is to protect access to health care and patient safety through California’s Medical Injury Compensation Reform Act.

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CAPP Board of Directors

American Nurses Association, California BETA Healthcare Group California Academy of Physician Assistants California Association for Nurse Practitioners California Association of Health Facilities California Dental Association California Healthcare Insurance Company California Hospital Association California Medical Association Central Valley Health Network Cooperative of American Physicians Kaiser Permanente Medical Insurance Exchange of California NORCAL Mutual Insurance Company Osteopathic Physician and Surgeons of California Physicians Reimbursement Fund The Dentists Insurance Company The Doctors Company

CAPP Coalition

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• Constant turnover in the legislature due to term limits
• Frequent educational opportunities through individual meetings

with legislative candidates

• Candidate questionnaires and candidate interviews with all CAPP

coalition members

• Political contributions determined by CAPP PAC

during endorsement process

• Fundraisers for current legislators in their

districts

Political Action Efforts to Protect MICRA

Photo courtesy of St. John’s Well Child & Family Center

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• Legislative efforts to increase non-

economic damages to make it easier to file lawsuits and increase attorney’s fees have failed on multiple

• ccasions.
• CAPP’s large and diverse coalition

continues to protect MICRA.

• Today, CAPP has the support of the

majority of California Assembly and State Senate members.

Legislative Efforts to Change MICRA

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• 100% of funding has come from trial lawyers and their allies.
• Prop. 46 includes three main components:

– Drug and alcohol testing for physicians:

• Random testing, administered by hospitals
• Testing after an “adverse event” at a hospital

– Mandatory use of the CURES prescription drug database. – Changes MICRA’s non‐economic damages cap to $1.1 million with annual increases going forward.

• The first two are “bait & switch” or “sweetener” provisions

designed to appeal to voters and mask the real intent: to change MICRA.

Proposition 46 Components

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• Quadruples MICRA’s non-economic damages cap from $250,000 to

$1.1 million on January 1, 2015, and increases annually for inflation.

• Trial lawyers will triple their legal fees
• Higher liability rates translates into to consumers paying higher

health care premiums.

• Doctors may leave California or stop practicing entirely.
• According to a study by California’s former Legislative Analyst, Prop.

46 will increase health care costs by $9.9 billion annually. This means it will cost a family of four more than $1,000 a year.

MICRA Change

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• Prop. 46 Time Line

July 2013 Language Submitted Oct 24, 2013 Amended Language Mar 24, 2014 Signatures Submitted May 15 Qualification June 30 Proposition Number Early Sept Broadcast Campaign Oct 7 Ballots Mailed Nov 4 Election Day!

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Trial Lawyer Tactics

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• Dr. Paul Phinney

Immediate Past President, California Medical Association

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Toe Tag Mailers

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Using Jahi McMath to Fundraise

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“No on Prop. 46” Coalition

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• Threatens People’s Personal Privacy
• Costly for Consumers
• Jeopardizes People’s Access to their Trusted Doctors

Talking Points

Increased costs. Losing your doctor. Threatening your privacy.

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• The No on 46 campaign is prepared

to do what it takes to defeat this costly and dangerous initiative, but we need your help.

• Please join the coalition, sign up for

updates, and request free campaign materials at www.NoOn46.com.

Get Involved!

Photo courtesy of La Clinica de la Raza

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Questions?