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Recent Reforms Enacted (since 2003)

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Alabama None
Alaska Lowered non-economic cap from 400K to 250K except in wrongful death or cases of severe permanent injury that is at least 70% disabling. Caps don’t apply in cases of reckless or intentional acts. (2005)
Arizona Requires expert witnesses to be in same specialty as defendant and be board certified if the defendant is. Expert must be in active practice or academic medicine during preceding 12 months. Protects statements of apology, responsibility or sympathy to a patient or family member from being admissible in court. (2005) Requires that liability suits must include an affidavit from a qualified physician within 60 days of filing the suit, confirming there are sufficient grounds. (2004) In 2009, the state enacted legislation increasing the burden of proof required in emergency care cases.
Arkansas 2003: Caps only punitive damages at the greater of $250,000 or three times the compensatory damages, not to exceed $1 million. Abolishes joint and several liability, requires affidavit of merit, provides venue reform and periodic payments.
California None
Colorado 2003: Reaffirmed $300,000 noneconomic cap, protects physician explanations/apologies to patients.
Connecticut None
Delaware Requires plaintiffs to obtain an affidavit of merit from a qualified expert. The expert must be a practicing physician who has been in the same or similar field as the defendant for the past three years. Additionally, if the defendant is Board Certified, then the expert must also be Board Certified in the same or similar field.
Florida Caps non-economic damages for physicians, other than in emergency care cases, at $500,000 with the exception of cases resulting in wrongful death or permanent vegetative state. Reforms expert witness law to require that the expert must be in the same or similar specialty as the defendant. (2003) Attorney contingency fees capped. (2004) Joint and Several Liability reform enacted (2006).  In 2011- Requirement that out of state physicians obtain a certificate from the Department of Health to provide expert witness testimony in medical liability cases and empowers the state medical and osteopathic boards to discipline those physicians for providing false or misleading testimony. (2011).
Georgia Eliminates joint and several liability. Upon the request of either party, the court must establish a schedule of payments for future damages exceeding $350,000. Requires expert witnesses to be practicing in the same specialty as the defendant. Requires plaintiff to file an affidavit of merit with each suit. Protects physicians who make any expressions of sympathy to a patient for an unanticipated outcome. Emergency care protection. (2005)
Hawaii None
Idaho Reduces non-economic damages cap to $250,000 per claimant, adjusted annually for inflation. The previous cap had grown to $682,000. Limits joint and several liability. (2003) Passed I'm Sorry protection for physician statements of apology. (2006)
Illinois Requires certificate of merit signed by expert before a case can go to trial, strengthens expert witness guidelines, provides "I'm Sorry" protection, and empowers state regulators to reject proposed liability insurance rate increases. (2005)
Indiana None
Iowa None
Kansas 2008-Pre-trial screening panels in med mal cases were enacted, with panel report admissible in subsequent trial.
Kentucky None
Louisiana Strengthens expert witness qualifications, including a requirement that the court consider whether the witness is board certified or has substantial experience in an area of medical practice relevant to the claim.
Maine I’m Sorry legislation enacted preventing statements of apology or sympathy (but not fault) from being admissible in court. (2005)
Maryland Passed a 2% tax on HMO premiums to fund state subsidy of some liability premiums and increased Medicaid payments to some specialists including emergency physicians. Capped premium rate increases for physicians at 5% in 2005, solidified noneconomic damage cap at $650,000 in most cases, stricter qualifications for expert witnesses, required a more detailed certificate of merit from an expert and required mediation before liability lawsuits proceed to trial. (2005)
Massachusetts Reduced the pre-judgment interest rate from 12 percent to a variable rate tied to the average rate of Treasury Bills.  2012 “Disclosure, Apology and Offer”, a key provision of the new state health cost law, deals with medical errors and malpractice by disclosing mistakes, apologizing to the patient and family when appropriate and offering compensation as a way to avoid litigation when possible.
Michigan 2012-adjusts caps on recoverable non-economic damages at $280,000 and reduces the total amount of future damages to present values at a rate of five percent per year, compounded annually, for each year in which those damages accrue.
Minnesota None
Mississippi Establishes a hard $500,000 cap on non-economic damages, deleting the exceptions to the cap. The new law also deletes the increases to the cap that were set to occur in 2011 and 2017. Abolishes joint liability. All medical liability actions can only be brought in the county in which the alleged act or omission occurred. (2004)
Missouri Joint and Several Liability protection for defendants not more than 50% at fault. Affidavit of merit required from expert in the same specialty as defendant. Periodic payments. I’m sorry protection for expressions of sympathy but not fault. For injuries that occur in Missouri, plaintiffs would have to file suit in the county where the alleged wrongful act or negligence first occurred. (2005) Requires insurance companies to base their medical liability rates on their loss-experience within the state, not losses in other states. Insurers must also give a 180-day notice if they plan to stop doing business in the state. (2006)
Montana Statements of apology, sympathy or benevolence are not admissible. Experts witnesses must be in the same specialty as the defendant and must be practicing or teaching within the last five years. (2005)
Nebraska None
Nevada Voter-passed initiative strengthens the $350,000 cap on noneconomic damages, provides for extended payments of awards, limits attorney fees to 40% of the first $50,000, 33.3% of the next $50,000, 25% of the next $500,000 and 15% of any additional award. Enacts collateral source and joint and several liability reforms. (2004)
New Hampshire Prevents liability lawsuits filed based on the "loss of opportunity" for an improved life.
New Jersey Creates a $78 million temporary fund to help cover costs of liability insurance. Fund paid by annual fee on physicians, attorneys, dentists, chiropractors and health facilities. Requires expert witnesses practice in the same specialty as the defendant and requires plaintiffs to file affidavit of merit, signed by a physician in the same specialty. Gives judges the authority to reduce awards they believe are excessive. Reduces from age 20 to 13 the statute of limitations for patients to file suit over injuries sustained at birth
New Mexico None
New York Froze liability premiums in 2008 and 2009.
North Carolina In 2011, the legislature overrode the governor's veto of SB33 and enacted reforms that include a $500K cap on non-economic damages (indexed for inflation) except in cases involving death, dismemberment when gross negligence occurred.  Emergency care provision was also enacted.
North Dakota None
Ohio Establishes a sliding cap on noneconomic damages, not to exceed the greater of $250,000 or 3X economic damages, up to a maximum of $350,000. Collateral sources of payment may be introduced. Abolishes joint and several liability. (2003). Allows the Director of Insurance to create a Medical Liability Underwriting Association upon a finding of need. $12 million placed in a Medical Liability Fund that can be used for the Medical Liability Underwriting Association or another medical malpractice initiative. Protects providers in expressing sympathy to a patient. Requires expert witnesses to practice in the same or substantially similar specialty as the defendant. Requires certificates of merit. Requires insurers to give advance notice before raising premiums or canceling policies. (2004)
Oklahoma Non-economic damage cap was lowered from $400K to $350K and strengthened so that the cap would not be removed based on degree of injury.  Cap could still be removed if clear and convincing evidnece of reckless disregard or gross negligence (2011). Affidavit of merit required.  Joint and several liability only applies if the defendant is 50% or greater at fault.  (2009) Protects a physician in expressing sympathy to a patient for an unintended outcome. (2004)
Oregon Sets aside $10 million per year from the state-owned workers’ compensation insurer to subsidize portions of liability premiums paid by physicians in rural parts of the state. Qualifying OBs could have up to 80% of their premiums paid. Most others would have up to 40% of their premiums subsidized.
Pennsylvania In 2011, new Joint and Several Liability reform enacted where defendants found to be less than 60% at fault can't be forced to pay more than their share of damages. In 2005, the Medical Care Availability and Reduction of Error (Mcare) Fund abatement program for Pennsylvania health-care providers was extended. MCARE is the state insurance fund that provides from $500,000 to $1 million of insurance for providers. Physicians received between a 50% and 100% abatement depending on the specialty. Emergency physicians were originally provided a 50% abatement, but in 2006 the governor expanded it to 100% for board certified physicians providing emergency care. in 2004, the state supreme court announced a rules change that allows judges to reduce jury awards they deem as excessive.
Rhode Island The presiding justice of the State Superior Court implemented an administrative order requireintg all medical liability cases in Providence County to first proceed through a mediation process. A separate order requires plaintiffs, within one year of filing suit, to disclose who their supporting experts are and to commit to a timeframe for deposition and discovery. (2005)
South Carolina Passed $350,000 cap per defendant. Requires plaintiffs to file an affidavit of merit signed by a qualified expert. Judges must report experts who provide egregious testimony to the licensing board. Either party may collect court costs and interest from the other party if the other party rejected an offer of settlement that was at least as favorable as the final verdict. Emergency care protection. (2005)
South Dakota None
Tennessee In 2011, a cap on noneconomic damages was enacted.  In medical liability cases, the cap was set at $750,000 except for when certain catastrophic injuries occur, in which the cap will be $1 million.
Texas Caps on non-economic damages are: $250,000 per physician per claimant, $250,000 per health care institution per claimant, and a second $250,000 per health care institution per claimant if the second institution is completely separate from the first. Periodic payments are mandatory for future medical expenses and discretionary for others. If either party in a medical lawsuit makes a reasonable settlement offer which is rejected, and the rejecting party loses the court judgment, the rejecting party may be liable for the offering party’s attorney fees and court costs. Plaintiff attorneys must file a report from an expert substantiating their charges within 90 days of filing the suit. Emergency care protection. (2003)
Utah In 2010, the cap on non-economic damages was revised to a hard cap of $450,000.  The previous cap has exceeded that amount due to annual adjustments for inflation, which were eliminated in this legislation. An affidavit of merit requirement was enacted as well in cases in which the pre-trial screening panel finds a case lacks merit. SB 79 was enacted in 2009 raising the standard of evidence required to prove negligence in emergency care cases from a preponderence of the evidence to clear and convincing evidence.  This law will sunset in 2013.
Vermont None
Virginia Total cap of $2M increased by $50K each year until reaching $3M in 2031.  The bill was supported by the state medical society (2011). Created a new insurance program within the Treasury Department to offer liability insurance to certain providers having difficulty securing coverage. Physicians using the state's risk-management insurance will be required to pay premiums set by the state, provide care to Medicaid beneficiaries, and enroll in a Virginia program for children injured at birth (2004). Certificate of Merit requirement, expressions of sympathy not admissible in court, mandatory assessment of providers who pay three liability claims in 10 years (2005).
Washington Reduced interest payments on jury awards, tied to a set two percent above market rates. In 2006, approved I'm Sorry protection for physician statements of apology within 30 days of an adverse event. A voluntary binding arbitration system was created, subject to a $1 million limit on damages. Juries are made aware of collateral source payments. The state insurance commissioner is authorized to approve rate increase requests. Hospitals required to report serious adverse events to the state within two days.
West Virginia Lowers non-economic cap to $250,000, except in cases involving loss of life, limb, or permanent physical or mental disability where cap is $500,000, adjusted for inflation. Modifies joint and several liability providing limited protection. Deducts payments received from collateral sources. Creates Certificate of Merit and strengthens expert witness qualifications. Authorizes tax credits for physicians to offset premium cost. Creates an insurer funded by a $1000 assessment per physician. Mandates state med. board to investigate physicians with 3 unfavorable judgments or with 5 judgments and settlements in 5 years. (2004) Protects statements of sympathy or apology from being admissible. (2005)
Wisconsin Following a 2005 Supreme Court ruling that threw out the existing non-economic damage cap, the state enacted a new higher cap of $750,000 in 2006.  Expert witness qualifications were strengthened in 2011.
Wyoming Set aside $13.2 million to create a low-interest loan program to help physicians purchase tail coverage if necessary. Medical review panel created to determine if "substantial" evidence exists for the case to proceed to trial. Panel findings are admissible in court. Certificate of merit required for panel filings.
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