The Battle to Protect MICRA Presented by Lisa Maas Executive Director Californians Allied for Patient Protection September 16, 2014 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
What is MICRA? 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 Photo courtesy of La Clinica de La Raza the cost of health care. 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
MICRA: The History 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
MICRA Provides 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. 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
MICRA Works Photo courtesy of Eisner Pediatric & Family Medical Center Photo courtesy of St. John’s Well Child & Family Center Photo courtesy of Operation Access 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
California vs. U.S. Premiums 1976 ‐ 2012 $ Billions 13.0 12.5 12.0 No Crisis in California 11.5 11.0 10.5 10.0 U.S. Premium 9.5 9.0 + 746%* 8.5 8.0 7.5 7.0 6.5 6.0 5.5 5.0 4.5 4.0 3.5 CA Premium 3.0 2.5 + 241% 2.0 1.5 1.0 0.5 0.0 76 78 80 82 84 86 88 90 92 94 96 98 '00 '02 '04 '06 '08 '10 '12 *Includes California Source: NAIC Profitability By Line By State 1976-2012 (Medical Malpractice) Prepared by: NORCAL Mutual 2/6/14 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
States Without Medical Liability Reform Suffer California Illinois New York (L.A./Orange (Cook/Madison/ (Nassau/Suffolk Counties) St. Clair Counties) 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 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Medical Liability Reforms Work Texas enacted medical liability reforms in 2003 and has since added more o 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 o obstetricians, 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 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
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. 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
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 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
CAPP Coalition 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Political Action Efforts to Protect MICRA 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 Photo courtesy of St. John’s Well Child & Family Center 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Legislative Efforts to Change MICRA Legislative efforts to increase non- • economic damages to make it easier to file lawsuits and increase attorney’s fees have failed on multiple occasions. 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. 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Proposition 46 Components • 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. 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
MICRA Change • 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. 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Prop. 46 Time Line July 2013 Oct 24, 2013 Mar 24, 2014 May 15 Language Amended Signatures Qualification Submitted Language Submitted June 30 Early Sept Oct 7 Nov 4 Proposition Broadcast Ballots Election Number Campaign Mailed Day! 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Trial Lawyer Tactics 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Dr. Paul Phinney Immediate Past President, California Medical Association 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Toe Tag Mailers 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Using Jahi McMath to Fundraise 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
“No on Prop. 46” Coalition 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Talking Points Threatens People’s Personal Privacy • Costly for Consumers • Jeopardizes People’s Access to their Trusted Doctors • Increased costs. Losing your doctor. Threatening your privacy. 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Get Involved! 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. Photo courtesy of La Clinica de la Raza 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
Questions? 2014 FALL CONFERENCE 2014 FALL CONFERENCE & TRAINING SEMINAR & TRAINING SEMINAR
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