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In the Courts-Legal Resources
Database Created from Lawsuit Decision
On Tuesday, October 27, New York Attorney General Andrew Cuomo announced the creation of a nationwide database to establish out-of-network reimbursement rates. The announcement ends a industry-wide probe into the insurance companies use of the flawed Ingenix database, which set reimbursement artificially low. The new database will be run by a newly-created nonprofit, Fair Health, Inc. It will be developed in conjunction with five New York-based universities. Cuomo expects the database to be operational within a year.
The attorney general’s investigation into the Ingenix system parallels the lawsuit AMA v. United HealthCare, of which MSMA is a named plaintiff. Hopefully, the announcement will facilitate a conclusion to the case, which is in the final stages of settlement. In January, United agreed to pay $350 million to settle various class actions brought against it concerning reimbursement rates. The judge has not yet approved that settlement.
Number of Malpractice Claims at an All-Time Low
The Missouri Department of Insurance, Financial Institutions and Professional Registration issued a report on Sept. 8, 2009, which details the number of malpractice claims filed in 2008. According to the report, 1,215 new malpractice claims were filed last year – a ten-year low. At the end of 2008, there were 3,017 open malpractice cases, which is the lowest number of pending cases in the 30 years the Department has been collecting data. The average claim was $202,612, which is up slightly compared to 2007.
The most common allegations in malpractice cases were poor surgical outcomes, non-surgical treatment, diagnostic errors, and patient safety. The full report can be read on the Department’s website.
Much of this can be attributed to the 2005 tort reform legislation spearheaded by MSMA.
Oral Arguments Scheduled
The Supreme Court will soon hear oral arguments in the case of Klotz v. St. Anthony’s, which challenges the constitutionality of the 2005 reforms enacted by the General Assembly. The MSMA, with the support of the AMA Litigation Center, will file an amicus brief in support of the 2005 law. The brief was due Oct. 29, 2009.
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