Date: 04/20/2009

Final
BILL SUMMARY for HB09-1344

HOUSE COMMITTEE ON JUDICIARY

Votes: View--> Action Taken:
Adopt prepared amendment L.001 (Attachment A). Th
Adopt prepared amendment L.002 (Attachment B). Th
Refer House Bill 09-1344, as amended, to the Commi
Pass Without Objection
Pass Without Objection
PASS



02:16 PM -- House Bill 09-1344

Representative Scanlan, prime sponsor, presented House Bill 09-1344 concerning adjustments for inflation to the limitations on medical negligence damages tied to regulatory oversight of the effects of such adjustments on medical negligence insurance. The bill makes a number of changes with regard to medical malpractice insurance in Colorado. Specifically, the bill:

The bill specifically includes all investment income, including income on surplus that may be reasonably allocable to Colorado insurance, for the purpose of calculating the profit of a medical malpractice insurer.

Representative Scanlan asked the committee to consider two amendments that significantly modify the bill.
BILL:HB09-1344
TIME: 02:22:07 PM
MOVED:Court
MOTION:Adopt prepared amendment L.001 (Attachment A). The amendment removes the adjustment to the medical malpractice damage caps. The motion passed without objection.

09HouseJud0420AttachA.pdf
SECONDED:Levy
VOTE
Apuan
Court
Gardner B.
King
Miklosi
Pace
Roberts
Excused
Ryden
Waller
McCann
Levy
Not Final YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:HB09-1344
TIME: 02:23:56 PM
MOVED:Court
MOTION:Adopt prepared amendment L.002 (Attachment B). The amendment imposes a fee on insurance carriers to pay for the hearings required by the bill. The motion passed without objection.

09HouseJud0420AttachB.pdf
SECONDED:Levy
VOTE
Apuan
Court
Gardner B.
King
Miklosi
Pace
Roberts
Excused
Ryden
Waller
McCann
Levy
Not Final YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

02:27 PM --
Natalie Brown, Colorado Trial Lawyers Association, spoke in support of the original bill. Ms. Brown expressed concern about the amendments to the bill that removed the adjustments to the damage caps for medical malpractice cases. She stated that, following the defeat of a bill from the 2008 legislative session that raised the damage caps, she was told it was reasonable to tie the caps to inflation. She stated her belief that the medical community had been less than honest in their negotiations about this issue.

02:33 PM --
Bruce Gustafson, representing himself, spoke in support of the original bill. Mr. Gustafson related details of his family's experience with medical malpractice. He expressed his belief that he was lied to by his daughter's doctors.

02:42 PM --
Steve Stone, representing himself, spoke in support of the original bill. Mr. Stone related details of his experience as the victim of medical malpractice, including the costs of being in a wheelchair, loss of his livelihood, and the loss of enjoyment of his life experiences.

02:55 PM --
David Woodruff, representing himself, spoke in support of the original bill. Mr. Woodruff is an attorney who primarily represents clients in medical malpractice cases. He stated the amended bill is not what he hoped for, but he asked the committee to support it regardless. Mr. Woodruff distributed an estimate of the effect of damage caps in medical malpractice cases (Attachment C). He walked the committee through the various charts included in the package of documents. Representative McCann distributed a report on limits on medical liability damage awards compiled by the National Conference on State Legislatures (NCSL) (Attachment D). Mr. Woodruff discussed the NCSL document and responded to questions from the committee.

09HouseJud0420AttachC.pdf 09HouseJud0420AttachD.pdf

03:18 PM --
Sam Fishbein, representing himself, spoke in support of the original bill. Mr. Fishbein related details of his experience as the husband of a victim of medical malpractice.

03:22 PM --
Janine Vitetta, representing herself, spoke in support of the original bill. Ms Vitetta related details of her experience as the mother of a victim of medical malpractice.

03:29 PM --
Rebecca Blasco, representing herself, spoke in support of the original bill. Ms. Blasco related details of her experience as the mother of a victim of medical malpractice.

03:36 PM --
Dr. Ben Vernon and Kari Hershey, Colorado Medical Society, spoke in opposition to the original bill. Dr. Vernon distributed written copies of his testimony and read his prepared remarks (Attachment E). He also distributed three information sheets about the bill (Attachments F-H). Ms. Hershey is the legal counsel for the Colorado Medical Society. She discussed medical malpractice cases and economic and non-economic damage awards. She talked about the difficulty in putting a monetary amount on the emotional pain and suffering that results from medical malpractice. She stated her belief that it would be proper to correct inefficiencies in the current liability litigation system. She offered a number of suggested changes. Dr. Vernon and Ms. Hershey responded to questions from the committee about the amendments made to the bill. Ms. Hershey discussed steps taken by medical malpractice insurance carriers to improve health care delivery. Dr. Vernon responded to questions regarding the reason why rural areas are losing physicians at a disproportionately high rate.

09HouseJud0420AttachE.pdf 09HouseJud0420AttachF.pdf

09HouseJud0420AttachG.pdf 09HouseJud0420AttachH.pdf

04:10 PM

Professor Thomas Russell was not able to testify, but distributed written information to the members of the committee (Attachment I).

09HouseJud0420AttachI.pdf

04:10 PM --
Dr. Ted Clarke, COPIC, and Julie Hoerner, State Farm Insurance Company, spoke in opposition to the bill. Dr. Clarke discussed COPIC and how it is organized. He distributed written information about the COPIC board of directors and insurance premium rates (Attachment J). He continued to speak about how COPIC is run. Ms. Hoerner is an insurance litigator. She explained the difference between Type I and Type II insurance Colorado. She reiterated testimony of prior witnesses that the amended bill seeks to fix a problem that does not exist. She discussed existing statutory provisions that allow an insured to request an explanation for rate increases, which may include the involvement of the Commissioner of Insurance. Every medical malpractice insurance carrier is subject to review by the Division of Insurance. Ms. Hoerner and Dr. Clarke responded to questions from the committee.

09HouseJud0420AttachJ.pdf

04:41 PM --
Robert Ferm, American Insurance Association and CNA Insurance, and Dick Brown, The Doctor's Company (medical malpractice insurance company), spoke in opposition to the bill. Mr. Brown discussed the medical malpractice insurance market, where 4 companies carry approximately 80 percent of the policies. He stated his belief that the bill will act as a disincentive toward competition. He talked about the intervenor role in the bill and the standards that might be established for those individuals. He expressed concern that the intervenors will not be responsible to anyone. Mr. Brown responded to questions from the committee about the insurance industry. Mr. Ferm explained the process of getting prior approval of insurance rates and whether it lends itself to more availability of product in the market. He indicated that the file and use system is much more effective and efficient. Mr. Ferm responded to questions from the committee about the competitive environment for insurers in Colorado.

05:08 PM --
Dr. Deborah Presken, representing herself, spoke in opposition to the bill. Dr. Presken discussed her experience with having to leave Chicago because of a negative malpractice climate. She stated that access to care and continuity of care suffer in environments where malpractice insurance is costly.

05:17 PM --
Dr. Gail Womack, Colorado Gynecological and Obstetrical Society, and Dr. Douglas Kirkpatrick, American College of Obstetrics and Gynecology, spoke in opposition to the bill. Dr. Womack distributed written information about the availability of obstetrical care in Colorado (Attachment K). She discussed the survey her organization conducted that focused on how liability laws affect availability of obstetrical care in the state. She talked extensively about the study. Dr. Kirkpatrick stated that, nationally, the average age of physicians ceasing to offer OB/GYN services is 48. He indicated that this is due to a 63 percent increase in liability. He related his personal experience as an OB/GYN physician and his fears about that type of practice. Other physicians experience the same caution and Medicaid patients suffer the most when physicians are no longer able to assume the risk.

09HouseJud0420AttachK.pdf

05:33 PM --
Marcy Morrison, Commissioner of Insurance, and Tom Able and John Postolowski , Division of Insurance, answered questions from the committee. Ms. Morrison addressed the review process for prior approval of insurance rates. She discussed the powers of her office, which include the review of rate increases that are excessive or discriminatory. She has not done such a review since she was appointed to her position. She responded to questions from the committee about possible rate hearings under the bill. Ms. Morrison discussed the costs of public hearings and who bears those costs.

05:51 PM --
Dr. Larry Kipe, representing himself, spoke in opposition to the bill. Dr. Kipe indicated that most of his practice is driven by cost and many practitioners in rural areas leave those areas because of high costs. He responded to a number of questions about practicing medicine in a rural areas.

05:56 PM --
Dr. John Bender, representing himself, spoke in opposition to the bill. Dr. Bender discussed the difficulty of practicing medicine in Larimer County. He stressed that this is not something the physicians are asking for and expressed confusion about why the bill is necessary.

06:00 PM --
Dr. Jeff Hurst, Colorado Dental Association, spoke in opposition to the bill. Dr. Hurst indicated that the fee that was amended into the bill by prepared amendment L.002 will be prohibitive to dentists who provide care to Medicaid patients. He discussed the impact of untreated dental care issues.

06:05 PM --
Dr. Charles Ray, representing himself, spoke in opposition to the bill. Dr. Ray runs a residency facility that trains family physicians and raised concerns about access to family care in Colorado. He wants to be able to recruit bright young physicians.

06:07 PM --
Dr. Mary Tuuk, Total Longterm Care, spoke in opposition to the bill. Dr. Tuuk distributed information about all-inclusive care for the elderly (Attachment L). She discussed the services provided by her program.

09HouseJud0420AttachL.pdf

06:14 PM --
Dr. Nate Watkins, Colorado ASAP, spoke in opposition to the original bill. Dr. Watkins is also opposed to the amended bill. He moved here because the medical malpractice climate is favorable to doctors. He appreciates the service he gets from COPIC and he is concerned that the bill will damage that relationship. He responded to questions from the committee about moving to Colorado because of the medical malpractice climate.

06:19 PM --
Dr. Eric Hanover, representing himself, stated that he is no longer necessarily opposed to the bill, but needs more time to consider it.

06:21 PM --
Sarah Staller, representing herself, spoke in opposition to the bill. Ms. Staller is a medical student and she is concerned about the malpractice climate in Colorado.

06:27 PM --
Dr. Neil O'Connor, American College of Emergency Physicians, spoke in opposition to the original bill and stated that the bill is a solution looking for a problem. Dr. O'Connor reiterated the testimony of previous witnesses.
BILL:HB09-1344
TIME: 06:41:14 PM
MOVED:Court
MOTION:Refer House Bill 09-1344, as amended, to the Committee on Appropriations with a favorable recommendation. Committee members commented about their positions on the bill. The motion passed on a vote of 7-4.
SECONDED:Pace
VOTE
Apuan
Yes
Court
Yes
Gardner B.
No
King
No
Miklosi
Yes
Pace
Yes
Roberts
No
Ryden
Yes
Waller
No
McCann
Yes
Levy
Yes
Final YES: 7 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS



06:42 PM

Representative Levy adjourned the committee.