A group of state lawmakers is studying a state Senate bill that would overhaul Georgia's medical malpractice system, with organizations such as the Medical Association of Georgia and the State Bar of Georgia lining up against it.
A Senate subcommittee heard testimony Tuesday from groups that oppose the legislation. It was the subcommittee's second hearing on Senate Bill 141, also known as the "Patient Injury Act," which would move medical malpractice claims out of the courts and into an administrative system overseen by a Patient Compensation Board within the Department of Community Health.
Earlier, lawmakers heard from health care administrators who have formed Patients for Fair Compensation, which is backing the bill. Those who oppose the measure say supporters are underestimating the costs and overstating the benefits of a patient compensation system.
"No other state has attempted such a drastic overhaul," said former state Sen. Arthur "Skin" Edge, a lobbyist for MAG Mutual Insurance Company, which provides medical liability insurance for doctors in nine states including Georgia. "Under this bill you will have more claims, higher costs, more reporting, higher taxes and more bureaucracy."
Sen. Brandon Beach, R-Alpharetta and the bill's sponsor, said he has received support from doctors who believe reforms are needed. He said the new system, which would be similar to the way worker's compensation claims are handled, would reduce health care costs. The legislation, as written, says medical malpractice litigation is a "costly and protracted process" with delays to receiving compensation averaging five years.
"Doctors went into medicine to heal people, to treat people. The last thing a doctor wants to do is to go into litigation," Beach said.
Beach said doctors are practicing defensive medicine by ordering unnecessary tests and procedures to reduce liability, which is driving up the cost of health care and exposing patients to medical risks. The bill acknowledges that a greater number of applications will qualify for compensation under the change.
"They are running tests just so they can say they checked it off a box. That is costing you and me as a consumer," Beach said. "It would protect the doctors so they would know they are not being sued in a court of law, that they would go before a panel and it would be a no-fault system. So then they would decrease the tests they order."
Dr. John Harvey testified on behalf of the Medical Association of Georgia, which represents nearly 8,000 physicians in the state. He said the primary concern is that costs will increase under the proposed new system.
"We need to be very careful about how we change the system, so that we're truly addressing the problems," Harvey said. "There are substantial concerns about how this proposal would proceed. While it's proposed as a no-fault system, it's hard for a physician to understand that if a claim is awarded."
Under the bill, a patient would submit a claim to a new Office of Medical Review, which would have 10 days to determine whether the application includes a medical injury. If it does, the doctor is notified and has 15 days to respond. If the doctor challenges the claim, then a team of experts will have 60 days to conduct an investigation. An independent medical review panel will issue a decision, which can be appealed by the doctor.
The system will not determine whether a doctor has committed medical malpractice, which is the responsibility of the Georgia Composite Medical Board.
"They are in front of their peers," Beach said. "If it was a true injury, then the patient is compensated and the doctor learns from that. But they don't have to be dragged through a court of law and their name ruined."
Former Attorney General Mike Bowers testified that the legislation raised constitutional questions and would not stand up under a legal challenge. Supporters have dismissed those claims, saying the public's right to seek remedy for an injury would remain and would simply transfer to an administrative process.
Charles L. Ruffin, president of the State Bar of Georgia, said his group opposes the bill.
"We are interested in seeing that everyone has the right to justice and trial by jury," Ruffin said. "We need to have an impartial judge overseeing an impartial jury making these decisions."
The system would be paid for with a set of fees paid annually by each provider to be set by the Patient Compensation Board. Members of the board would be appointed by the governor, the lieutenant governor and the speaker of the Georgia House. The bill says fees for an individual physician would not exceed $500 in the first fiscal year and $600 in subsequent years, while fees for a hospital would not exceed $100 per bed in the first fiscal year and $200 per bed in subsequent years.