Bill targets insurance rates for rural doctors

JEFFERSON CITY, Mo. -- A proposal by some Southeast Missouri lawmakers intended to lower medical malpractice insurance rates for rural doctors has been added to a larger bill on insurance reform.

The Republican-sponsored insurance bill is a companion measure to legislation Gov. Matt Blunt signed into law last month that will overhaul Missouri's civil litigation system. Doctors championed the litigation bill as vital to controlling lawsuits for medical error and reducing their malpractice insurance costs. Blunt and others, however, have acknowledged that insurance reform is also needed to achieve that aim.

A key provision of the litigation measure requires lawsuits to be filed in the county where an alleged harm occurs. The intent is to stop the practice of venue shopping in which plaintiffs seek to move cases to jurisdictions, such as St. Louis and Kansas City, where juries have reputations for providing high financial damage awards.

Democratic state Reps. J.C. Kuessner of Eminence and Terry Swinger of Caruthersville filed a bill to require insurers to calculate medical malpractice rates for doctors in third- and fourth-class counties, the state's smallest, separately from those for doctors in larger counties. Currently, rates are based on statewide malpractice liability.

Following the logic put forth by supporters of tighter venue restrictions that more conservative rural juries are likely to be less generous than their urban counterparts, Kuessner and Swinger argued rural areas should reap the benefit.

Venue shopping

"If we are going to stop venue shopping, we ought to have malpractice rates based on what happens in a certain venue," said Swinger, an optometrist.

Although their bill went nowhere on its own, Kuessner amended it to the larger insurance reform bill before the House of Representatives approved in earlier this month. He did so with changes offered by state Rep. Richard Byrd, R-Kirkwood, that would require rates to be set on a county-by-county basis. Byrd is sponsoring the main bill, which is pending in the Senate.

Kuessner said Byrd accepted the amendment after it proved popular with rural lawmakers. If doctors find their malpractice liability is lower in rural areas, Kuessner said it would provide doctors an incentive to practice in those rural areas.

"This makes the total legislation a rural health initiative," Kuessner said. "If you want the lowest rates in the state, you can move into the counties with low-dollar lawsuits."

As a first-class county, Cape Girardeau County wouldn't have benefited from Kuessner's original bill but would stand to under the current version.

The overall bill would give the Missouri Department of Insurance greater oversight over medical malpractice insurance providers. It would also make it more difficult for companies to increase rates by more than 20 percent.

The bill is HB 394.

mpowers@semissourian.com

(573) 635-4608