Independent medical providers say rising malpractice ceiling threatens to shut them down Legislation | New Mexico Legislative Session

dr Gabrielle Adams, dressed in her white doctor’s coat, moved through the halls of the State Capitol hoping to speak to every legislator she could find.

“I was running around trying to grab people,” said Adams, president of Albuquerque-based Southwest Gastroenterology.

Her goal was to persuade lawmakers to approve a bill that would limit medical malpractice payouts to $750,000 for independent ambulatory health care facilities that are not majority-owned by a hospital.

If Senate Bill 296 fails, multiple providers will seek insurance to cover medical malpractice ceilings of $6 million through 2027 – the rate for hospitals.

Legislators passed an update to the state’s medical malpractice law in 2021, raising the ceilings on civil claims payouts in a phased process over several years and adding some independent outpatient clinics to the hospital category, a move that has been criticized by the legislature and Health care advocates.

Adams said the change could mean practices go uninsured or go out of business.

The report on the tax implications of the bill states, “The New Mexico Medical Society notes that there are over 450 licensed outpatient healthcare facilities in New Mexico, including state, hospital-owned and independent facilities.”

Annie Jung, executive director of the New Mexico Medical Society, said 11 of those facilities would be affected by the law change.

“But they serve thousands,” she said.

Some lawmakers, mostly Republicans, have urged their peers to reconsider the change this year, blaming the higher caps for exacerbating New Mexico’s shortage of healthcare providers.

SB 296, which has a Democratic and Republican sponsor, could face hurdles. The House Health and Human Services Committee introduced a companion bill, House Bill 88, in a 7-3 party vote a week ago.

Rep. Elizabeth “Liz” Thomson, D-Albuquerque, said New Mexico will lose health care providers before the malpractice ceiling goes up. There are many reasons for the shortages, but “medical malpractice, I don’t think it’s a serious one,” she said.

In the meantime, there are behind-the-scenes talks about how to improve SB 296. Sen. Mark Moores, R-Albuquerque, a sponsor of the bill, said in an interview that lawmakers are meeting Saturday with trial attorneys, members of Gov. Michelle Lujan, Grisham’s administration and Democratic senators to introduce a mutually acceptable bill.

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“Hopefully we’ll see action next week,” Moores said, adding that if Democrats don’t come on board to do something about the issue, “they own the issue.”

He said a “quirk of the law” puts independent outpatient clinics in the same league as hospitals when it comes to caps on medical malpractice payouts.

He joked that malpractice attorneys “will have no one left to sue” when clinics close and doctors leave the state.

Vendors, attorneys, patients weigh in

At the very least, providers’ insurance premiums will go up unless their malpractice limits are lowered, Adams said. In the worst case, the institutions cannot find an insurance carrier.

She said her clinic had unsuccessfully sought insurance coverage for the $6 million ceiling.

In a state grappling with a provider shortage that leaves clinics with two options, Adams said: work under-insured or “close our doors.” Some of us are retiring, some of us are moving away, some of us are working for Presbyterians or something.”

Lobbyists, attorneys and patients involved in medical malpractice cases have also spoken to lawmakers about SB 296, arguing that it unfairly deprives a patient of the ability to claim higher medical malpractice costs that can be severe emotional, mental, or emotional and caused physical harm.

dr Jeff Greene – he says the “Dr” is now just a formality that he no longer practices dentistry – he’s a tall, imposing figure in his late 40s with one disfigured eye.

He said laser surgery in 2016 went wrong, resulting in a tear in his retina and severe nerve damage.

After years of follow-up surgery on the eye, an eye expert recommended removing the eye, so “I did it,” he said. “I’m no longer in pain, but I don’t have the depth perception necessary to continue in dentistry.”

He was trying to practice in Albuquerque for a few years, until one day a teenage patient’s tooth broke off a piece of the root tip. Greene struggled to deal with it.

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“I knew what I was doing to this patient was hurting,” he said. “My own limitation was affecting this patient negatively, and I vowed to myself that I couldn’t be that kind of doctor. For [the patients’] For my own safety, I had to resign.”

Greene sued and got what he said less than what he made in a year as a dentist.

“I still have significant college debt, a family… all the hard work I went through to become a doctor was taken away from me,” he said. “I got a year’s severance pay and an apology that ‘we screwed up your life.’ ”

Now studying to become a lawyer, he campaigns against SB 296. He argues a $750,000 cap is unfair to patients losing a limb, eyes, life — or a little of what they used to be.

He doesn’t believe the argument that insurance companies don’t offer $6 million in insurance policies, and he doesn’t believe for a minute that another argument is being made by SB 296 proponents: that health workers are leaving the state in droves because of the high levels of medical care Misconduct Limits.

Are caps to blame for the shortage of providers?

In many critical areas, New Mexico lacks medical professionals. A legislative report released in the summer of 2021 identified numerous gaps: 328 general practitioners, 238 registered nurses, 249 physician assistants, 524 physical therapists, 2,510 paramedics, 521 pharmacists and 117 psychiatrists.

The New Mexico Health Care Workforce Report shows that between 2013 and 2021, the number of general practitioners practicing in the state fell from 1,957 to 1,607.

Do Physician Liability Caps Play a Role in the Scarcity? Health officials say yes; Patients and lawyers say no.

SB 296 proponents say the higher malpractice limit will cause public health officials to pack up and leave or shut down the state.

Christ St. Vincent Regional Medical Center will not be affected by an increase in caps beyond the $6 million it is now facing, but Dr. Theresa Ronan said she was concerned about patients losing access to regional outpatient health facilities if some close. She fears the current law will result in few insurance companies willing to insure the smaller operators.

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“The result is that perhaps thousands of patients could lose access to medical care,” she said. “New Mexico is already understaffed. … Any closure is disastrous for patients. Where would they go?”

Nick Autio, general counsel of the New Mexico Medical Society, agrees. He, too, said there are few insurers willing to take the risk of covering small, independent outpatient health care facilities, and he believes medical malpractice rates play a “large role” in the state’s shortage of health care providers play.

Medical malpractice rates are “definitely a driving force for the exodus,” he said.

Zackeree Kelin, an Albuquerque-based attorney whose practice handles many medical malpractice cases, argued that there is no evidence or study showing medical malpractice leads to provider closures or exits.

“I don’t know what they associate with the claim that providers are dropping out because of medical malpractice insurance rates or their ability to get coverage,” he said.

He also hasn’t seen any data to suggest providers can’t find insurance carriers just because prices are rising, he said. Noting that about half of the states in the country have no medical malpractice limits, Kelin said providers there shouldn’t have trouble finding insurance.

Citing neighboring Arizona, home of the Mayo Clinic, Kelin said, “Nobody would argue that there’s a massive insurance problem there or that doctors are leaving the state because they don’t have a medical malpractice limit.”

While New Mexico clearly faces a shortage of medical workers, he believes studies of declining numbers don’t account for doctors who simply stop practicing even if their licenses are still valid.

It’s difficult to really study or interpret the impact of higher medical malpractice rates without knowing a healthcare facility’s win-or-loss scale, he added.

“I think there’s a sense for all professionals that their premiums are too high,” Kelin said. “Well, ‘too high’ is really in the eye of the beholder.”