Lawmakers Debate Medical Liability Reform and Search for Solutions to Budget Crunch

The NCMS government affairs staff worked overtime this week as a flood of healthcare related issues hit the desks of legislators. The Senate Judiciary 1 Committee held its third and fourth meetings to discuss SB 33 Medical Liability Reforms, a bill that continues to undergo changes as various members of the committee address concerns over caps for non-economic damages in lawsuit awards and over other provisions that would change how medical malpractice cases are handled in North Carolina. Your staff is in daily negotiations with committee leaders and members to motivate the enactment of meaningful medical liability reform for North Carolina physicians.

Speaker of the House Thom Tillis (R,  Mecklenburg) attended the first committee meeting of the House Select Committee on Tort Reform this week and urged its members to “walk the walk” to develop a tort reform bill that is fair for the public, for businesses and for the state’s physicians. The committee, chaired by Representative Johnathan Rhyne (R, Lincoln) and Representative Danny McComas (R, New Hanover) met on Thursday morning and heard testimony from individuals representing the American Tort Reform Association, the North Carolina Advocates for Justice and Sammy Thompson, a medical malpractice defense attorney who spoke on behalf of the North Carolina Medical Society. The committee is currently accepting feedback on the issue with the goal of creating a comprehensive and fair tort reform bill in the coming weeks. In the meantime, Representative Bill Faison (D, Caswell, Orange) a medical malpractice plaintiff’s attorney from Orange County has filed two bills in the House regarding medical malpractice insurance.

  • HB 154 – Reform Medical Malpractice Evidentiary Rules, which would allow a plaintiff’s attorney to present evidence or inquire about the existence of an amount of a defendant’s medical malpractice insurance coverage during a medical malpractice trial, including during jury selection procedures.
  • HB 155 – Medical Malpractice Insurance Coverage, which would require the NC Department of Insurance to develop a classification rating plan for medical malpractice insurance, requiring that insurance rates be based upon the number of licensed and practicing physicians in the state and not on the specialty of the physician.  This bill would cause the rates for many specialties to skyrocket.

By the end of the legislative week, we find Governor Perdue steadfast in her resolve to protect spending priorities for attracting business, creating new jobs and education. On Monday, the Governor vetoed SB 13, the Balanced Budget Act of 2011, which would have given her authority to cut an additional $400 million from state agencies and programs. 

GOP leaders responded to the veto by reportedly telling subcommittee chairs to consider consolidating or eliminating certain initiatives and programs and not include any expansion items in their budget proposals. House Speaker Thom Tillis summed up the budget negotiations saying “everything is on the table” as budget writers continue to hunt for solutions to balance spending and revenue.

This week the state’s Medicaid budget took center stage in these discussions. With a proposed budget target cutting the Department of Health and Human Services as much as half a billion dollars,  the House Appropriations Sub-Committee on Health and Human Services heard presentations by Amerigroup, MedSolutions, Value Options, Triad Healthcare and even a former Medicaid  director from Georgia to solicit solutions to the proposed deficit.   Community Care of North Carolina, the public private partnership that saves the state more than $200 million annually, was a part of the discussion in some of these presentations and absent from others.

Other legislative activity of note this week:

  • SB 58 – Modify FMAP Cuts/Authorize Use of Credit Balance, passed easily through the Senate this week, finding quick approval through both committee and floor votes. SB 58 is expected to be heard in the House next week.  This bill will disallow a proposed $26 million cut to Medicaid provider rates approved in last year’s budget.
  • SB 32 – Hospital Medicaid Assessment/Payment Program, also easily passed through Senate committee and floor votes this week and is expected to be taken up in the House next week.
  • HB 115 – North Carolina Health Benefit Exchange Act, a bill filed to lay out the framework and operations of the NC Health Benefit Exchange, mandated by the federal Affordable Care Act.  The NCMS government affairs team has been involved in hours of negotiations this week to address concerns about the governance and implementation of these exchanges as currently proposed.
  •  HB 2 – Protect Health Care Freedom, Governor Perdue chose not to veto this bill, which seeks to remove North Carolina from parts of the federal health care reform law. By letting the measure remain unsigned for ten days, it becomes law without further action by the Governor.

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