Opinions? VA and FL State Law : Birth Injury Comp Fund

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SweetMD

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I posted this in the Ob/Gyn and FM forum, because it affects them directly (and people don't cross-browse the forums much, or do they? 😳), but I really would like to hear my own specialty's opinion on this... and especially considering that we don't seem to be addressed directly by these funds even though we do deliver babies (although we try not to).

Since recently aquiring licensure in mentioned state I received a letter with the order to pay $290 or $5400 (my choice!) into the child brain injury fund by state law. I had not heard of this mandatory program before and could not find anything under the "forum search" function about it either, so forgive me if it was previously discussed.

My questions:

Do any OB/Gyns/Family Practioners here have experience with this program?
If so, do you feel it has made life better or worse for your patients and/or you?
What do other specialty physicians think?
Is this effective in dealing with the medical malpractice crisis in the country?
Is it fair (or lawful!) to tax physicians as a group?
Who should pay for the care of neurologically impaired children?
Would you like or hate to have this in YOUR state?
Any other thoughts on this?



Here's some information and background:

In response to increasing costs of medical malpractice insurance and insurers withdrawing from the market in the late 1980s, Virginia and Florida both created funds to compensate families for the lifetime medical expenses they incur when their child is born severely impaired because of neurological injuries suffered during the birthing process. Infants were singled out because lawsuits associated with these cases have a relatively high success rate and successful cases tend to result in large monetary awards. The fund and claims process is an alternative to malpractice litigation. If a family is eligible for coverage, it cannot pursue a malpractice claim; if it is found ineligible for coverage, it can then litigate.

In both states the fund is capitalized by annual assessments from physicians and hospitals. In both, physicians who participate in the program pay $ 5,400 per year and hospitals pay $ 50 per live birth. Participation in both states is voluntary. Doctors and hospitals that participate do not have to face malpractice suits if an infant is found eligible for compensation and was delivered at a participating hospital by a participating provider . All other (nonparticipating) physicians in the states must pay $ 290. Virginia also assesses liability insurers. Florida initially capitalized the fund with a $ 20 million state appropriation.

If eligible, a family receives payment for all necessary and reasonable expenses for medical, hospital, rehabilitative, residential, and custodial care and services; special equipment or facilities; and related travel, except those expenses that have already been paid by a private insurance policy or a government program. The family is also compensated for the cost of filing the claim, including attorney’s fees. In Virginia, it is compensated for the child’s lost earnings, while in Florida parents receive an award of up to $ 100,000.

In Virginia, the Workers’ Compensation Commission determines whether a child is eligible; in Florida it is an administrative law judge from the State Management Department.

Studies estimate each child will need payments averaging $1.74 million (last assessment 2002), but children who live into adulthood would require much higher payments.


Official VA fund website: http://www.vabirthinjury.com/WhoWeAre.htm
Official FL fund website: http://www.nica.com/


One critic of the fund writes:

Florida physicians recently challenged the Florida Birth-Related Neurological Injury Compensation Plan's similar action to tax all physicians to raise funds. The case was heard in the Florida Supreme Court: Justice Kogan, joined by Justice Barkett and Chief Justice Shaw, observed: "[T]he state has enacted a program designed in principle to benefit the public as a whole, but that effectively benefits only obstetricians who elect to join the plan and those persons who suffer losses caused by certain birth related injuries attributable to the member obstetricians. While this is a laudable purpose, I can find no rational basis for imposing much of the burden of this program primarily on physicians as a class....I think this particularly is true in light of the fact that obstetricians are not obliged to join the plan, and many have exercised this option." They also were troubled by the imposition of a "status tax"' on physicians to pay for insurance against certain birth related injuries. Such a tax is no different, in their opinion, from "taxing only schoolteachers to pay for new educational facilities, or taxing only licensed psychologists to pay for public mental health care, or taxing only policemen to pay for victims' compensation programs."


... much more can be found on this, but mainly it seems from lawyers' sites like this website by a FL law firm: http://florida-nica.com/, some older state comissioned reports and assessments (newest from 2004?) ... do physicians and their organizations have no voice in this or did I just not find it yet???

I'll start with this... opinions?
 
opinions?[/B]

Crappy, crap, crap.

I think it sucks. Physicians are being forced to pay the malpractice costs of mother nature. Let the damn lawyers sue mother nature and let her pay her own premiums.

Bastards.

Take care,
Jeff
 
That's why I left FL. I have heard way too many horrible stories of very very good EPs being pushed out of there because of the legal climate.

That being said, now that I live in VA (which is one of the states with the fund) things are a bit different, but as a whole, VA is a very very very friendly physician state.

Of course, I practice across the water in DC, which is like a whole other country....

Q
 
That's why I left FL. I have heard way too many horrible stories of very very good EPs being pushed out of there because of the legal climate.
Q

See, and I always thought FL was a physician friendly state, because of their cap on "pain and suffering", joint liability reform, limit on attorney fees...
And haven't they implemented that "protection for EM physicians" with a cap for all lawsuits involving EM care??

Well, in the meantime I can say that the local medical society supports this "physicians tax" because they view it as a lesser of two evils. The guy I talked to was telling me that the malpractice insurers basically left the state 10 years ago, drawing all the ob's with them, and of course FP s overall have been limiting their OB part of the practice across the nation.
So they came up with this fund, and the insurers came back into the state, and each year the trial lawyer association is trying to overthrow the "cap" of the state, the only reason they haven't been able to is supposedly the existence of this fund! The funny (or sad) thing is that the initial state law had lawyers paying into the fund, too! Of course, they got rid of that part of the law right away! And because of funding problems (they now project more than $2 Mio per brain injured child until adulthood) they instead added all the physicians of the state (when initially it was only OBs and FPs).

This is the part that I think is especially ludicrous : A psychiatrist has no more to do with the birth injury of children than any other citizen in that state! Why does he have to pay into it?
And for us it sucks even more, because as an emergency physician you will pay into this fund every year, yet if you do have to deliver a baby in your ER, you wouldn't be covered, and the baby not eligible to enter the fund/get the benefits.

So he told me for 2009 it's supposed to be $320/year from every physician and so on!!! Until they realize that it can't be funded like that...
 
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