UPDATE

Focus on Practice

By Joan R. Rose

The FTC slays another physician group

Without admitting any wrongdoing, the Carlsbad [NM] Physician Association has agreed to settle price-fixing and restraint-of-trade charges. The FTC had alleged that the group refused to deal with payers except on collectively agreed-upon terms. "Because the group includes most of the doctors in the Carlsbad area, health plans had no choice but to contract with them. . . . to the detriment of the area's consumers," said Joe Simons, director of the FTC's Bureau of Competition. Under a proposed consent order, the group will dissolve, and its executives will be barred from acting as the messenger or agent in other health plan contracting matters. This is the sixth time in 18 months that the FTC has charged a physician group with illegal collective bargaining, and the Carlsbad penalties are similar to those put in place in the previous cases.

Texas caps damages—and then some

A new Texas law imposes a $250,000 cap on noneconomic damages against physicians in a lawsuit, regardless of how many doctors are named. The cap, Gov. Rick Perry's office notes, will "deter trial lawyers from skirting the reforms by suing every doctor who saw the patient." In addition, there is a $250,000 cap on noneconomic damages against a single institution and a $500,000 cap on institutions combined, meaning that the most plaintiffs will be able to collect for pain and suffering will be $750,000. They will still be able to recover the full amount of their medical bills and lost wages and, in some cases, punitive damages—if determined by a unanimous jury.

The new legislation also aims to limit frivolous malpractice claims by tightening up the Good Samaritan law, and requiring plaintiffs to provide an expert witness report within four months of filing suit.

Texas lawmakers have also passed a measure that will ask voters on Sept. 13 to approve an amendment to the state constitution authorizing legislators to limit noneconomic awards. If that authority isn't expressly spelled out in the constitution, lawmakers say, challenges to cap laws could be tied up in the courts for years.

Honoring practices that use electronic records

If you're part of an independent primary care practice that uses electronic health records, you may be eligible for the Healthcare Information and Management Systems Society's Primary Care Davies Award. The award recognizes practices that have successfully used an electronic records system to improve the caliber of care they deliver. Candidates must have fewer than 33 physicians, all of whom must use the electronic system. Moreover, the records should have been in place long enough to provide evidence of how they have improved efficiency, quality, service, and staff or patient satisfaction. Guidelines for applying are available at www.himss.org/content/files/DaviesGuidelines_ipc.pdf. Applications must be received by Aug. 15.

Watch out for this malpractice insurer

Earlier this year, Oregon insurance regulators ordered First Actual American Insurance to stop selling medical malpractice coverage in the state. The company uses a Canby, OR, post office address but isn't authorized to do business in Oregon. Since then, at least eight other states—Alabama, California, Georgia, Mississippi, Missouri, Nevada, North Dakota, and Ohio—have issued cease-and-desist orders or warned physicians against the same company. Given the scarcity of affordable malpractice insurance, physicians may be tempted by FAAI's claim to provide coverage at 30-50 percent below rates charged by other insurers. Regulators suggest that before you purchase any coverage, check with your state insurance department to be sure the company is licensed to do business in your state.

For patients, health is a weighty problem

Despite CDC estimates that 65 percent of American adults are overweight, only one-third of those recently surveyed by WirthlinWorldwide see themselves as too heavy. When asked who is most responsible for keeping them healthy, two out of three respondents pointed to themselves. Nevertheless, significant numbers are looking to government and industry to take responsibility as well.

 

Joan Rose. UPDATE: Focus on practice. Medical Economics Jul. 25, 2003;80:11.