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Medical Liability Reform

PROBLEM:  In state civil justice systems that lack reasonable limits on liability, multi-million dollar jury awards and settlements in medical liability cases have forced many insurance companies to either leave the market or substantially raise costs.  Increasingly, physicians in these states are choosing to stop practicing medicine, abandon high-risk parts of their practices, or move their practices to other states. 

ATRA’S POSITION:  To help bring a degree of predictability and fairness to the civil justice system that is critical to solving the growing medical access and affordability crisis, ATRA recommends a medical liability reform packages that includes: (1) a $250,000 limit on noneconomic damages; (2) a sliding scale for attorney’s contingent fees; (3) periodic payment of future damages; and (4) abolition of the collateral source. 

OPPOSITION:  The personal injury bar likes to argue that only insurance companies are to blame for the current medical liability crisis.  Pointing to significant declines in the stock market, they blame insurance companies for raising rates to make up for allegedly irresponsible investing practices.  But market fluctuations cannot fully explain the sharp increases in medical liability insurance pricing, especially since insurance companies invest only 13% of their total investments in stocks.  A better explanation of why insurance companies have raised rates is that they have had to cover the cost of increased claim payments, which have risen almost three times the rate of inflation in recent years.

Alaska

Medical Liability Reform/Noneconomic Damages Reform: S.B. 67 (2005). Lowers the limit on noneconomic damages in medical liability cases to $250,000.  In the most severe cases involving disfigurement, severe permanent physical impairment, and wrongful death, the limit on noneconomic damages is $400,000.  The previous limit on noneconomic damages ranged from $400,000 to $1 million, depending on the severity of the injuries.

Medical Apology: H.B. 250 (2014). Makes an expression of apology, responsibility, liability, sympathy, commiseration, compassion or benevolence by a health care provider inadmissible in a medical liability case.  It also requires a health care provider to advise a patient to seek legal advice before making an agreement with the patient to correct an unanticipated outcome of medical treatment or care.   

Alabama

Medical Liability Reform: Wrongful Death: (1987). Limits damages in wrongful death actions to $1 million.

California

Medical Liability Reform: Noneconomic Damages Reform: The Medical Injury Compensation Reform Act (MICRA): (1975): Cal. Civ. Code § 333.2. Limits noneconomic damages in medical liability cases to $250,000.  The $250,000 limit on noneconomic damages in medical liability actions does not violate the equal protection or due process provisions of the State or Federal Constitutions.  Fein v. Permanente Medical Group, 695 P.2d 665 (Cal.), appeal dismissed, 474 U.S. 892 (1985).

Medical Liability Reform: Contingent Fee Reform: The Medical Injury Compensation Reform Act (MICRA): (1975): Cal. Bus. & Prof. Code § 6146(a). Limits contingent fees in medical liability cases to 40% of the first $50,000 recovered, 33.3% of the next $50,000, and 15% of any amount exceeding $600,000.

Colorado

Medical Liability Reform: Noneconomic Damages Reform: SB 143 (1988): Colo. Rev. Stat. § 13-64-302. Limits the total award of damages to $1,000,000, of which no more than $250,000 can be for noneconomic damages.  The $250,000 limit on noneconomic damages in medical liability actions is constitutional.  Scholz v. Metropolitan Pathologists, P.C., No. 92‑8A277, Co. Sup. Ct., April 26, 1993.

Medical Liability Reform: Punitive Damages: HB 1069 (1990). Provides that punitive damages shall not be alleged in a professional negligence suit until discovery is substantially completed. Provides that discovery cannot be reopened without an amended pleading. Provides that physicians cannot be held liable for punitive damages because of the bad outcome of a prescription medication as long as it was administered in compliance with current FDA protocols.  Prohibits punitive damages from being assessed against physicians because of the act of another unless he directed the act or ratified it.

Medical Liability Reform: Noneconomic Damages Reform: HB 03-1007 (2003). Limits noneconomic damages in medical malpractice cases to $300,000.

Florida

Medical Liability Reform: Noneconomic Damages: CS/SB6 (1988): Fla. Stat. §§ 766.207, 766.209. Limits noneconomic damages in medical liability cases to $250,000 in arbitration.  Limits noneconomic damages in medical liability cases to $350,000, if the plaintiff refuses to arbitrate.  Sets no limit on noneconomic damages in medical liability cases, where neither party demands binding arbitration, or where the defendant refuses to arbitrate.

Medical Liability Reform: Nursing Homes: Punitive Damages: SB 1202 (2001). Requires a plaintiff to prove punitive damages by clear and convincing evidence in cases against nursing home facilities.  Limits punitive damages against nursing home facilities to the greater of three times the award of compensatory damages or $1 million.  Limits punitive damages against nursing home facilities to the greater of $4 million or four times the award of compensatory damages, where conduct is proven to be motivated by financial gain.  Sets no limit on the award of punitive damages against nursing home facilities, where intentional harm is proven. 

Medical Liability Reform: Noneconomic Damages Reform: CS SB 2-D (special session 2003). Provides for emergency room practitioner limits on noneconomic damages of $150,000 per claimant, with an aggregate of $300,000.  Provides for emergency room facility limits on noneconomic damages of $750,000 per claimant, with an aggregate of $1.5 million and full setoffs for practitioner payments.  Provides for non-practitioner limits on noneconomic damages of $750,000 per claimant, with an aggregate for all claimants.  Provides for practitioner limits on noneconomic damages of $500,000 per claimant, with an aggregate limit for all claimants of $1 million, but no single practitioner shall be liable for more than $500,000 regardless of the number of claimants.

Medical Liability Reform: Expert Evidence: H.B. 7015 (2013) Provides that a witness qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion as to the facts at issue in a case under certain circumstances.  It requires the state to interpret and apply the principles of expert testimony in conformity with the United States Supreme Court’s decision in the Daubert case. 

Georgia

Medical Liability Reform/Noneconomic Damages Reform: S.B. 3 (2005). Limits noneconomic damages to $350,000 per healthcare provider, with an overall aggregate limit of $1.05 million.

Illinois

Medical Liability Reform: Noneconomic Damages Reform: SB 475 (2005). Limits noneconomic damages in medical liability cases to $500,000 per physician and $1 million per hospital.

Michigan

Medical Liability Reform: Noneconomic Damages: SB 270/H 2 (1993): Mich. Comp. Laws § 600.1483. Limits the award of noneconomic damages in medical liability cases to $280,000 for ordinary occurrences, and $500,000 if the claimant has suffered brain damage, spinal cord damage, damage to the reproductive system which prevents procreation, or injury to cognitive ability that leaves the plaintiff unable to live alone.

Medical Liability Reform: Noneconomic Damages Reform: S.B. 1115 (2012) Classifies the loss of household or other services, loss of companionship and loss of consortium as noneconomic damages.  

Medical Liability Reform: Prejudgment Interest Reform: S.B. 1118 (2012) Ensures that a full 91-day period is given to defendants who submit an affidavit of meritorious defense and ends the practice of prejudgment interest being awarded on attorney fees and costs in medical liability cases. 

Missouri

Medical Liability Reform: Noneconomic Damages: H.B. 393 (2005). Limits noneconomic damages in medical liability cases to a nonadjustable limit of $350,000 regardless of the number of defendants in the case.

Mississippi

Medical Liability Reform: Joint and Several Liability Reform: H.B.2 (special session) (2002); Amended Miss. Code Ann. § 85-5-7. Replaces the rule of joint and several liability with the rule of proportionate liability for noneconomic damages (that is, limit a joint tortfeasor’s liability for noneconomic damages to his percentage of fault).  Replaces the rule of joint and several liability with the rule of proportionate liability for economic damages, where the defendant is found to be less than 30% at fault.  Replaces the rule of joint and several liability with a rule that allows a joint tortfeasor to be held up to 50% responsible for economic damages, where the defendant is found to be at least 30% at fault.

Medical Liability Reform: Noneconomic Damages Reform: H.B.2 (special session) (2002); Amended Miss. Code Ann. § 85-5-7. Limits noneconomic damages to $500,000 until July 1, 2011, $750,000 from July 1, 2011 until July 1, 2017, and $1 million after July 1, 2017, not adjusted for inflation, unless a judge were to determine that a jury could impose punitive damages. Prohibits the disclosure to a jury of the noneconomic damages limit.

Medical Liability Reform: Noneconomic Damages Reform: H.B. 13 (special session) (2004); Amended Miss. Code Ann. § 11-1-60. Establishes a hard cap of $500,000 on noneconomic damages in medical liability cases (the $500,000 cap that was passed during a special session in 2002 contained an escalator clause which would have raised the cap to $750,000 in 2011 and $1 million in 2017).

Montana

Medical Liability Reform: Noneconomic Damages Reform: HB 309 (1995): Mont. Code Ann. § 25‑9‑411. Limits the award of noneconomic damages in medical malpractice cases to $250,000. 

North Carolina

Medical Liability Reform: Noneconomic Damages Reform: SB 33 (2011);N.C. Gen. Stat. § 90-21.19. Limits noneconomic damages in medical liability cases to $500,000 against all defendants.  The limit is subject to adjustments, every three years starting on January 1, 2014, based on the Consumer Price Index.  The legislation does provide for an exception to the limit if: (1) the plaintiff suffered disfigurement, loss of use of part of the body, permanent injury or death; and (2) the defendant's acts or failures, which are the proximate cause of the plaintiff's injuries, were committed in reckless disregard of the rights of others, grossly negligent, fraudulent, intentional or with malice.

New Hampshire

Medical Liability Reform: Noneconomic Damages Reform: A New Hampshire law setting a $250,000 limit on noneconomic damages in medical liability cases was held unconstitutional in Carson v. Maurer, 424 A.2d 825 (N.H. 1980). A $875,000 cap on noneconomic damages was held unconstitutional in Brannigan v. Usitalso, 587 A.2d 1232 (N.H. 1980)). 

Nevada

Medical Liability Reform: Emergency Room Liability: AB 1 (2002). Limits damages in medical liability cases against emergency room physicians to $50,000.

Medical Liability Reform: Noneconomic Damages Reform: AB 1 (2002). Limits noneconomic damages in medical liability cases to $350,000, except upon a showing of “gross malpractice” or a judicial determination that there is “clear and convincing evidence” that the noneconomic award should exceed the cap. 

Ohio

Medical Liability Reform: Noneconomic Damages: SB 281 (2003); ORC Ann. 2323.43. Limits the award of noneconomic damages in medical liability cases to $350,000, with a provision to allow the cap to rise to $1 million, depending on the severity of the injuries and the number of plaintiffs involved in the suit.

Oklahoma

Medical Liability Reform: Noneconomic Damages: SB 629 (2003): 63 O.S. § 1-1708.1F. Limits the award of noneconomic damages to $350,000 in cases involving pregnancy (labor, delivery, and post partum period) as well as emergency care.

Medical Liability Reform: Noneconomic Damages: H.B. 2661 (2004). Extends the sunset provision on the limit on noneconomic damages for ob/gyn’s and emergency care situations (S.B. 629, 2003) from July 1, 2008 until November 1, 2010.

Medical Liability Reform: Expert Evidence: S.B. 6 (2013) Adopts the federal rules of evidence.  Sets out that a qualified expert witness may testify on scientific, technical or other specialized knowledge if; (1) The testimony is based upon sufficient facts or data; (2) the testimony is the product of reliable principles and methods; and (3) the witness has applied the principles and methods reliably to the facts of the case.  Also sets out that facts or data that are otherwise inadmissible shall no tbe disclosed to the jury by the proponent of the opinion or inference unless the court determines that their probative value in assisting the jury to evaluate the expert’s opinion substantially outweighs their prejudicial effect.

Pennsylvania

Medical Liability Reform: Collateral Source Rule Reform: HB 1802 (2002): 40 Pa. Cons. Stat. Ann. § 1301.602. Prohibits a patient from suing for damages that were paid by a health insurer.

Medical Liability Reform: Benevolent Gestures: S.B. 379 (2013) Allows health care providers to make benevolent gestures prior to the start of medical malpractice lawsuits, mediations, arbitrations or administrative actions and not have those statements or gestures of contrition used against them as long as such actions are not statements of negligence or fault.

Rhode Island

Medical Liability Evidence Reform: H.B. 7559 (2012) Expands the type of medical services and expense affidavits that can be introduced into evidence without the provider being required to testify in court.

South Carolina

Joint and Several Liability Reform: Medical Liability: S. 83 (2005). Specifies that if there are multiple defendants in a civil action, joint and several liability does not apply to any defendant 50 percent or less responsible for the damages.  Furthermore, specified that comparative fault is included in the calculation of total fault in the case.  If the plaintiff is found to be greater than 50 percent responsible for the total fault, then the plaintiff is completely barred from recovering damages.  A defendant found to be less than 50 percent responsible is only responsible for its proportional share of damages based on its percentage of liability.  Retained the right of the “empty chair” defense where a defendant retains the right to assert that another potential tortfeasor, whether or not a party,  contributed to the alleged damages and may be liable for any or all damages alleged by another party.

Medical Liability Reform: Noneconomic Damages: S. 83 (2005). Limits noneconomic damages in medical liability cases to $350,000 per provider, with an overall aggregate limit of $1.05 million. 

Texas

Medical Liability Reform: Noneconomic Damages Reform: HB 4 (2003). Limits the award of noneconomic damages in medical malpractice cases to $250,000 against all doctors and health care practitioners and a $250,000 per-facility cap against health care facilities such as hospitals and nursing homes, with an overall cap of $500,000 against health care facilities, creating in effect an overall limit of noneconomic damages in medical malpractice cases of $750,000.

Utah

Medical Liability Reform: Arbitration: H.B. 135 (2013) Provides that a party in a medical liability action or arbitration may not attempt to allocate fault to any health care provider unless a certificate of compliance has been issued.  Also, requires that evidence from a medical review panel remain unreportable to a health care facility or health insurance plan.

Virginia

Medical Liability Reform: Expert Witness Certification: H.B. 1545 (2013) States that in an action for medical liability, the court, upon showing good cause, may conduct an in camera review of the opinion obtained by the plaintiff of an expert witness who certified that the defendant deviated from the applicable standard of care and the deviation was the proximate cause of the injuries claimed.

Medical Liability Reform: Expert Witness: S.B. 699 Requires the plaintiff, in medical liability cases, to provide certification of expert witnesses.  The plaintiff must disclose the identity and qualifications of the expert witness who certified that the defendant deviated from the applicable standard of care and the deviation was the proximate cause of the injuries claimed.  The certification is required before the plaintiff can commence any action for medical liability.

Wisconsin

Medical Liability Reform: Noneconomic Damages Reform: AB 36 (1995): Wisc. Stat. Ann. §§ 893.55, 895.04. Limits the award of noneconomic damages in medical liability cases to $350,000, indexed for inflation.  The $350,000 limit on noneconomic damages awards in medical liability cases did not violate the right to jury trial, separation of powers, remedy for wrongs, equal protection, or  due process provisions of the State constitution.  Guzman v. St. Francis Hospital, Inc., 2000 WL 1848463 (Wis. App. Dec. 19, 2000).

West Virginia

Medical Liability Reform: Noneconomic Damages Reform: HB 2122 (2003): W.V. Code Ann. § 55-7B-8. Limits the award of noneconomic damages in medical malpractice cases to $250,000 to $500,000 depending on the severity of the injuries.

2014
Alaska
Medical Apology: H.B. 250 (2014).

Makes an expression of apology, responsibility, liability, sympathy, commiseration, compassion or benevolence by a health care provider inadmissible in a medical liability case.  It also requires a health care provider to advise a patient to seek legal advice before making an agreement with the patient to correct an unanticipated outcome of medical treatment or care. 

 

2013
Oklahoma
Medical Liability Reform: Expert Evidence: S.B. 6 (2013)

Adopts the federal rules of evidence.  Sets out that a qualified expert witness may testify on scientific, technical or other specialized knowledge if; (1) The testimony is based upon sufficient facts or data; (2) the testimony is the product of reliable principles and methods; and (3) the witness has applied the principles and methods reliably to the facts of the case.  Also sets out that facts or data that are otherwise inadmissible shall no tbe disclosed to the jury by the proponent of the opinion or inference unless the court determines that their probative value in assisting the jury to evaluate the expert’s opinion substantially outweighs their prejudicial effect.

2013
Florida
Medical Liability Reform: Expert Evidence: H.B. 7015 (2013)

Provides that a witness qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion as to the facts at issue in a case under certain circumstances.  It requires the state to interpret and apply the principles of expert testimony in conformity with the United States Supreme Court’s decision in the Daubert case

2013
Virginia
Medical Liability Reform: Expert Witness Certification: H.B. 1545 (2013)

States that in an action for medical liability, the court, upon showing good cause, may conduct an in camera review of the opinion obtained by the plaintiff of an expert witness who certified that the defendant deviated from the applicable standard of care and the deviation was the proximate cause of the injuries claimed.

2013
Virginia
Medical Liability Reform: Expert Witness: S.B. 699

Requires the plaintiff, in medical liability cases, to provide certification of expert witnesses.  The plaintiff must disclose the identity and qualifications of the expert witness who certified that the defendant deviated from the applicable standard of care and the deviation was the proximate cause of the injuries claimed.  The certification is required before the plaintiff can commence any action for medical liability.

2013
Pennsylvania
Medical Liability Reform: Benevolent Gestures: S.B. 379 (2013)

Allows health care providers to make benevolent gestures prior to the start of medical malpractice lawsuits, mediations, arbitrations or administrative actions and not have those statements or gestures of contrition used against them as long as such actions are not statements of negligence or fault.

2013
Utah
Medical Liability Reform: Arbitration: H.B. 135 (2013)

Provides that a party in a medical liability action or arbitration may not attempt to allocate fault to any health care provider unless a certificate of compliance has been issued.  Also, requires that evidence from a medical review panel remain unreportable to a health care facility or health insurance plan.

2012
Michigan
Medical Liability Reform: Noneconomic Damages Reform: S.B. 1115 (2012)

Classifies the loss of household or other services, loss of companionship and loss of consortium as noneconomic damages.  

2012
Michigan
Medical Liability Reform: Prejudgment Interest Reform: S.B. 1118 (2012)

Ensures that a full 91-day period is given to defendants who submit an affidavit of meritorious defense and ends the practice of prejudgment interest being awarded on attorney fees and costs in medical liability cases. 

2012
Rhode Island
Medical Liability Evidence Reform: H.B. 7559 (2012)

Expands the type of medical services and expense affidavits that can be introduced into evidence without the provider being required to testify in court.

2011
North Carolina
Medical Liability Reform: Noneconomic Damages Reform: SB 33 (2011);N.C. Gen. Stat. § 90-21.19.

Limits noneconomic damages in medical liability cases to $500,000 against all defendants.  The limit is subject to adjustments, every three years starting on January 1, 2014, based on the Consumer Price Index.  The legislation does provide for an exception to the limit if: (1) the plaintiff suffered disfigurement, loss of use of part of the body, permanent injury or death; and (2) the defendant's acts or failures, which are the proximate cause of the plaintiff's injuries, were committed in reckless disregard of the rights of others, grossly negligent, fraudulent, intentional or with malice.

2005
Alaska
Medical Liability Reform/Noneconomic Damages Reform: S.B. 67 (2005).

Lowers the limit on noneconomic damages in medical liability cases to $250,000.  In the most severe cases involving disfigurement, severe permanent physical impairment, and wrongful death, the limit on noneconomic damages is $400,000.  The previous limit on noneconomic damages ranged from $400,000 to $1 million, depending on the severity of the injuries.

2005
South Carolina
Medical Liability Reform: Noneconomic Damages: S. 83 (2005).

Limits noneconomic damages in medical liability cases to $350,000 per provider, with an overall aggregate limit of $1.05 million. 

2005
Missouri
Medical Liability Reform: Noneconomic Damages: H.B. 393 (2005).

Limits noneconomic damages in medical liability cases to a nonadjustable limit of $350,000 regardless of the number of defendants in the case.

2005
South Carolina
Joint and Several Liability Reform: Medical Liability: S. 83 (2005).

Specifies that if there are multiple defendants in a civil action, joint and several liability does not apply to any defendant 50 percent or less responsible for the damages.  Furthermore, specified that comparative fault is included in the calculation of total fault in the case.  If the plaintiff is found to be greater than 50 percent responsible for the total fault, then the plaintiff is completely barred from recovering damages.  A defendant found to be less than 50 percent responsible is only responsible for its proportional share of damages based on its percentage of liability.  Retained the right of the “empty chair” defense where a defendant retains the right to assert that another potential tortfeasor, whether or not a party,  contributed to the alleged damages and may be liable for any or all damages alleged by another party.

2005
Georgia
Medical Liability Reform/Noneconomic Damages Reform: S.B. 3 (2005).

Limits noneconomic damages to $350,000 per healthcare provider, with an overall aggregate limit of $1.05 million.

2005
Illinois
Medical Liability Reform: Noneconomic Damages Reform: SB 475 (2005).

Limits noneconomic damages in medical liability cases to $500,000 per physician and $1 million per hospital.

2004
Mississippi
Medical Liability Reform: Noneconomic Damages Reform: H.B. 13 (special session) (2004); Amended Miss. Code Ann. § 11-1-60.

Establishes a hard cap of $500,000 on noneconomic damages in medical liability cases (the $500,000 cap that was passed during a special session in 2002 contained an escalator clause which would have raised the cap to $750,000 in 2011 and $1 million in 2017).

2004
Oklahoma
Medical Liability Reform: Noneconomic Damages: H.B. 2661 (2004).

Extends the sunset provision on the limit on noneconomic damages for ob/gyn’s and emergency care situations (S.B. 629, 2003) from July 1, 2008 until November 1, 2010.

2003
Oklahoma
Medical Liability Reform: Noneconomic Damages: SB 629 (2003): 63 O.S. § 1-1708.1F.

Limits the award of noneconomic damages to $350,000 in cases involving pregnancy (labor, delivery, and post partum period) as well as emergency care.

2003
Colorado
Medical Liability Reform: Noneconomic Damages Reform: HB 03-1007 (2003).

Limits noneconomic damages in medical malpractice cases to $300,000.

2003
Texas
Medical Liability Reform: Noneconomic Damages Reform: HB 4 (2003).

Limits the award of noneconomic damages in medical malpractice cases to $250,000 against all doctors and health care practitioners and a $250,000 per-facility cap against health care facilities such as hospitals and nursing homes, with an overall cap of $500,000 against health care facilities, creating in effect an overall limit of noneconomic damages in medical malpractice cases of $750,000.

2003
Florida
Medical Liability Reform: Noneconomic Damages Reform: CS SB 2-D (special session 2003).

Provides for emergency room practitioner limits on noneconomic damages of $150,000 per claimant, with an aggregate of $300,000.  Provides for emergency room facility limits on noneconomic damages of $750,000 per claimant, with an aggregate of $1.5 million and full setoffs for practitioner payments.  Provides for non-practitioner limits on noneconomic damages of $750,000 per claimant, with an aggregate for all claimants.  Provides for practitioner limits on noneconomic damages of $500,000 per claimant, with an aggregate limit for all claimants of $1 million, but no single practitioner shall be liable for more than $500,000 regardless of the number of claimants.

2003
West Virginia
Medical Liability Reform: Noneconomic Damages Reform: HB 2122 (2003): W.V. Code Ann. § 55-7B-8.

Limits the award of noneconomic damages in medical malpractice cases to $250,000 to $500,000 depending on the severity of the injuries.

2003
Ohio
Medical Liability Reform: Noneconomic Damages: SB 281 (2003); ORC Ann. 2323.43.

Limits the award of noneconomic damages in medical liability cases to $350,000, with a provision to allow the cap to rise to $1 million, depending on the severity of the injuries and the number of plaintiffs involved in the suit.

2002
Mississippi
Medical Liability Reform: Noneconomic Damages Reform: H.B.2 (special session) (2002); Amended Miss. Code Ann. § 85-5-7.

Limits noneconomic damages to $500,000 until July 1, 2011, $750,000 from July 1, 2011 until July 1, 2017, and $1 million after July 1, 2017, not adjusted for inflation, unless a judge were to determine that a jury could impose punitive damages. Prohibits the disclosure to a jury of the noneconomic damages limit.

2002
Mississippi
Medical Liability Reform: Joint and Several Liability Reform: H.B.2 (special session) (2002); Amended Miss. Code Ann. § 85-5-7.

Replaces the rule of joint and several liability with the rule of proportionate liability for noneconomic damages (that is, limit a joint tortfeasor’s liability for noneconomic damages to his percentage of fault).  Replaces the rule of joint and several liability with the rule of proportionate liability for economic damages, where the defendant is found to be less than 30% at fault.  Replaces the rule of joint and several liability with a rule that allows a joint tortfeasor to be held up to 50% responsible for economic damages, where the defendant is found to be at least 30% at fault.

2002
Pennsylvania
Medical Liability Reform: Collateral Source Rule Reform: HB 1802 (2002): 40 Pa. Cons. Stat. Ann. § 1301.602.

Prohibits a patient from suing for damages that were paid by a health insurer.

2002
Nevada
Medical Liability Reform: Emergency Room Liability: AB 1 (2002).

Limits damages in medical liability cases against emergency room physicians to $50,000.

2002
Nevada
Medical Liability Reform: Noneconomic Damages Reform: AB 1 (2002).

Limits noneconomic damages in medical liability cases to $350,000, except upon a showing of “gross malpractice” or a judicial determination that there is “clear and convincing evidence” that the noneconomic award should exceed the cap. 

2001
Florida
Medical Liability Reform: Nursing Homes: Punitive Damages: SB 1202 (2001).

Requires a plaintiff to prove punitive damages by clear and convincing evidence in cases against nursing home facilities.  Limits punitive damages against nursing home facilities to the greater of three times the award of compensatory damages or $1 million.  Limits punitive damages against nursing home facilities to the greater of $4 million or four times the award of compensatory damages, where conduct is proven to be motivated by financial gain.  Sets no limit on the award of punitive damages against nursing home facilities, where intentional harm is proven. 

1995
Montana
Medical Liability Reform: Noneconomic Damages Reform: HB 309 (1995): Mont. Code Ann. § 25‑9‑411.

Limits the award of noneconomic damages in medical malpractice cases to $250,000. 

1995
Wisconsin
Medical Liability Reform: Noneconomic Damages Reform: AB 36 (1995): Wisc. Stat. Ann. §§ 893.55, 895.04.

Limits the award of noneconomic damages in medical liability cases to $350,000, indexed for inflation.  The $350,000 limit on noneconomic damages awards in medical liability cases did not violate the right to jury trial, separation of powers, remedy for wrongs, equal protection, or  due process provisions of the State constitution.  Guzman v. St. Francis Hospital, Inc., 2000 WL 1848463 (Wis. App. Dec. 19, 2000).

1993
Michigan
Medical Liability Reform: Noneconomic Damages: SB 270/H 2 (1993): Mich. Comp. Laws § 600.1483.

Limits the award of noneconomic damages in medical liability cases to $280,000 for ordinary occurrences, and $500,000 if the claimant has suffered brain damage, spinal cord damage, damage to the reproductive system which prevents procreation, or injury to cognitive ability that leaves the plaintiff unable to live alone.

1990
Colorado
Medical Liability Reform: Punitive Damages: HB 1069 (1990).

Provides that punitive damages shall not be alleged in a professional negligence suit until discovery is substantially completed. Provides that discovery cannot be reopened without an amended pleading. Provides that physicians cannot be held liable for punitive damages because of the bad outcome of a prescription medication as long as it was administered in compliance with current FDA protocols.  Prohibits punitive damages from being assessed against physicians because of the act of another unless he directed the act or ratified it.

1988
Florida
Medical Liability Reform: Noneconomic Damages: CS/SB6 (1988): Fla. Stat. §§ 766.207, 766.209.

Limits noneconomic damages in medical liability cases to $250,000 in arbitration.  Limits noneconomic damages in medical liability cases to $350,000, if the plaintiff refuses to arbitrate.  Sets no limit on noneconomic damages in medical liability cases, where neither party demands binding arbitration, or where the defendant refuses to arbitrate.

1988
Colorado
Medical Liability Reform: Noneconomic Damages Reform: SB 143 (1988): Colo. Rev. Stat. § 13-64-302.

Limits the total award of damages to $1,000,000, of which no more than $250,000 can be for noneconomic damages.  The $250,000 limit on noneconomic damages in medical liability actions is constitutional.  Scholz v. Metropolitan Pathologists, P.C., No. 92‑8A277, Co. Sup. Ct., April 26, 1993.

1987
Alabama
Medical Liability Reform: Wrongful Death: (1987).

Limits damages in wrongful death actions to $1 million.

1980
New Hampshire
Medical Liability Reform: Noneconomic Damages Reform:

A New Hampshire law setting a $250,000 limit on noneconomic damages in medical liability cases was held unconstitutional in Carson v. Maurer, 424 A.2d 825 (N.H. 1980). A $875,000 cap on noneconomic damages was held unconstitutional in Brannigan v. Usitalso, 587 A.2d 1232 (N.H. 1980)). 

1975
California
Medical Liability Reform: Contingent Fee Reform: The Medical Injury Compensation Reform Act (MICRA): (1975): Cal. Bus. & Prof. Code § 6146(a).

Limits contingent fees in medical liability cases to 40% of the first $50,000 recovered, 33.3% of the next $50,000, and 15% of any amount exceeding $600,000.

1975
California
Medical Liability Reform: Noneconomic Damages Reform: The Medical Injury Compensation Reform Act (MICRA): (1975): Cal. Civ. Code § 333.2.

Limits noneconomic damages in medical liability cases to $250,000.  The $250,000 limit on noneconomic damages in medical liability actions does not violate the equal protection or due process provisions of the State or Federal Constitutions.  Fein v. Permanente Medical Group, 695 P.2d 665 (Cal.), appeal dismissed, 474 U.S. 892 (1985).

Texas
Medical Liability Reform: Wrongful Death: Tex. Rev. Civ. Stat. art. 4590i § 11.02.

Limits damages in wrongful death actions to $500,000. The statute originally limited damages in all negligence actions, but the Texas Supreme Court held it unconstitutional except as to wrongful death actions in Rose v. Doctors Hospital, 801 S.W.2d 841 (Tex. 1990)  .

New Hampshire
Medical Liability Reform: Collateral Source Rule Reform.

A New Hampshire statute abolishing the collateral source rule was found to be unconstitutional in Carson v. Maurer, 424 A.2d 825 (N.H. 1980).

Wisconsin
Medical Liability Reform: Contingent Fee Reform: Wisc. Stat. Ann. § 655.013.

Limits contingent fees to 1/3 of the first $1 million recovered, 25% of the first $1 million recovered if liability is stipulated within 180 days of filing of the original complaint and not within 60 days of first day of trial, and 20% for amounts exceeding $1 million recovered.  Allows a judge to exceed these amounts in exceptional circumstances.

Hawaii
Medical Liability Reform: Contingent Fee Reform: Haw. Rev. Stat. § 607-15.5.

Limits contingent fees in medical liability cases to a “reasonable amount,” as determined by the court.

Wyoming
Medical Liability Reform: Contingent Fee Reform: Wyo. Ct. Rules Ann. Contingency Fee R. 5.

Limits contingent fees in medical liability cases to: one-third of the recovery, if the claim settles within 60 days of the filing of the lawsuit; forty percent of the recovery, if the claim is settled after 60 days or a judgment is entered upon a verdict; and 30 percent of any recovery exceeding $1 million.

Massachusetts
Medical Liability Reform: Noneconomic Damages Reform: Mass. Gen. Laws Ann. Ch. 231 § 60-H.

Limits noneconomic damages in medical liability cases to $500,000, unless the claimant can show "a substantial or permanent loss or impairment of a bodily function or substantial disfigurement."

Indiana
Medical Liability Reform: Contingent Fee Reform: Ind. Code Ann. § 34-18-18-1.

Limits contingent fees in medical liability cases to 15% of the recovery that comes from the Patient’s Compensation Fund.  

South Dakota
Medical Liability Reform: Noneconomic Damages Reform: S.D. Codified Laws § 21-3-11.

Limits noneconomic damages in medical liability cases to $500,000.

Michigan
Medical Liability Reform: Collateral Source Rule Reform: Mich. Comp. Laws § 600.6303.

Provides for medical liability awards to be offset by collateral sources, less any premiums paid to obtain the benefit. 

Iowa
Medical Liability Reform: Contingent Fee Reform: Iowa Code Ann. § 147.138.

Provides that a court in medical liability cases “shall determine” the reasonableness of the contingency fee. 

Montana
Medical Liability Reform: Collateral Source Rule Reform: Mont. Code Ann. § 27‑1‑308.

Provides for awards to be offset by collateral sources that do not involve rights of subrogation in medical liability cases for awards over $50,000.

Maine
Medical Liability Reform: Contingent Fee Reform: Me. Rev. Stat. Ann. tit. 24 § 2961.

Limits contingent fees in professional liability cases to 33.3% of the first $100,000 recovered, 25% of the next $100,000 recovered, and 20% of any amount recovered over $2 million.  Permits a judge to allow fees in excess of these amounts in special circumstances.

Delaware
Medical Liability Reform: Collateral Source Reform: Del. Code Ann. tit. 18 § 6862.

Permits the admissibility of evidence of collateral source payments in medical liability actions.

Nebraska
Medical Liability Reform: Collateral Source Rule Reform: Neb Stat. § 44-2819.

Allows evidence of nonreturnable medical reimbursement insurance in medical liability cases to be taken as a credit against any judgment rendered.

Massachusetts
Medical Liability Reform: Contingent Fee Reform: Mass. Gen. Laws Ann. Ch. 231 § 60-I.

Limits contingent fees in medical liability cases to 40% of the first $150,000 recovered, 33.3% of the next $150,000 recovered, 30% of the next $200,000 recovered, and 25% of any amount over $500,000 recovered.

Utah
Medical Liability Reform: Noneconomic Damages Reform: Utah Code Ann. § 78-14-7.1.

Limits noneconomic damages in medical liability cases to $250,000.

Nevada
Medical Liability Reform: Collateral Source Rule Reform: Nev. Rev. Stat. Ann. § 42.020.

Provides for awards in medical liability cases to be offset by the amount received by a collateral source, including any prior payment by the defendant health care provider.  

Michigan
Medical Liability Reform: Contingent Fee Reform: Mich. Ct. R. 8.121.

Limits contingent fees in medical liability cases for personal injury or death to 33.3% of the amount recovered.

Minnesota
Medical Liability Reform: Contingent Fee Reform: Minn. Stat. Ann. § 548.36.

Requires that contingent fees in medical liability cases be based on the award adjusted for collateral source benefits.

Alaska
Medical Liability Reform: Contingent Fee Reform: Alaska Stat. § 9.60.080.

Requires that contingent fees be calculated exclusive of punitive damages.

New York
Medical Liability Reform: Collateral Source Rule Reform: N.Y. C.P.L:R § 4545(a).

Permits the admissibility of evidence of collateral source payments in medical liability cases.

Nebraska
Medical Liability Reform: Contingent Fee Reform: Neb Stat. § 44-2834.

Allows a court to review contingent fees in medical and professional liability cases.

New Hampshire
Medical Liability Reform: Contingent Fee Reform: N.H. Rev. Stat. Ann. § 508:4-e.

Requires a court to approve contingent fees exceeding $200,000 in medical liability cases.

Indiana
Medical Liability Reform: Damages Limits: Ind. Code Ann. § 34-18-14-3.

Limits the total amount recoverable in medical liability cases to $750,000 for acts that occur before July 1, 1999, and $1,250,000 for acts that occur after July 1, 1999.  Requires any amount awarded in excess of these limits to be paid from the Patient’s Compensation Fund.

Rhode Island
Medical Liability Reform: Collateral Source Rule Reform: R.I. Gen. Laws § 9-19-34.1.

Permits the admissibility of evidence collateral source payments from “state income disability or workers’ compensation, any health, sickness or income disability policy, or other contracts” for reimbursement.  Requires a jury to reduce damages awards by the amount paid by collateral sources, if such evidence is introduced.

New Jersey
Medical Liability Reform: Contingent Fee Reform: N.J. Ct. R. § 1:21-7.

Limits contingent fees in medical liability cases pursuant to a sliding scale provided in the New Jersey Court Rules.

Wisconsin
Medical Liability Reform: Wrongful Death Damages Reform: Wisc. Stat. Ann. §§ 893.55, 895.04.

Limits damages in wrongful death cases to $500,000 for a minor and $350,000 for an adult.

Arizona
Medical Liability Reform: Contingent Fee Reform: Ariz. Rev. Stat. § 12-568.

Allows a court to consider the reasonableness of attorneys’ fees in medical liability cases, taking into account factors such as “the time and labor required, the novelty and difficulty of the questions involved, and the skill requisite to perform the legal skills properly.”

South Dakota
Medical Liability Reform: Collateral Source Rule Reform: S.D. Codified Laws § 21-3-12.

Permits the admissibility of evidence of collateral source payments when the claimant alleges special damages that are or will be paid by insurance, are not subject to subrogation, and are not purchased privately or by government programs. 

New York
Medical Liability Reform: Contingent Fee Reform: N.Y. Jud. Law § 474-a.

Limits contingent fees in medical liability cases by a sliding scale.

Maine
Medical Liability Reform: Noneconomic Damages Reform: Me. Rev. Stat. Ann. tit. 24-A § 4313.

Limits noneconomic damages against a carrier of a health plan to $400,000.

Tennessee
Medical Liability Reform: Collateral Source Reform: Tenn. Code Ann. § 29-26-119.

Provides for economic damages to be offset in medical liability cases by collateral sources, except for sources including the assets of the plaintiff and the immediate family, or insurance purchased by the plaintiff in whole or in part. 

New Mexico
Medical Liability Reform: Damages Limits: N.M. Stat. Ann. § 41-5-6, 41-5-7.

Limits total damages in medical liability cases to $600,000, except for punitive damages and medical care and related benefits.

Oklahoma
Medical Liability Reform: Contingent Fee Reform: Okla. Stat. Ann. tit.5, § 7.

Limits contingent fees to 50% of a plaintiff’s recovery.

Connecticut
Medical Liability Reform: Contingent Fee Reform: Conn. Gen. Stat. Ann. § 52‑251c.

Limits contingent fees in medical liability cases to 33.3 % of the first $300,000 recovered, 25% of the next $300,000, 20% of the next $300,000, 15% of the next $300,000, and 10% of any amount exceeding $1.2 million.

Utah
Medical Liability Reform: Collateral Source Rule Reform: Utah Code Ann. § 78-14-4.5.

Provides for awards to be offset by collateral source payments, excluding any source for which a subrogation right exists and any amount paid by plaintiff or the immediate family to secure the benefit.

Tennessee
Medical Liability Reform: Contingent Fee Reform: Tenn. Code Ann. § 29-26-120.

Requires a judge to award contingent fees in medical liability cases not to exceed 33.3%.

Delaware
Medical Liability Reform: Contingent Fee Reform: Del. Code Ann. tit. 18 § 6865.

Limits contingent fees in medical liability cases to 35% of the first $100,000 recovered, 25% of the next $100,000, and 10% of the balance.

Washington
Medical Liability Reform: Collateral Source Rule Reform: Wash. Rev. Code Ann. § 7.70.080.

Permits the admissibility of evidence of collateral source payments in medical liability cases, except if the source is an insurance policy that the plaintiff or a member of the immediate family purchased with his or her assets.

Utah
Medical Liability Reform: Contingent Fee Reform: Utah Code Ann. § 78-14-7.5.

Limits contingent fees in medical liability cases to 1/3 of the amount recovered.

Florida
Medical Liability Reform: Contingent Fee Reform: Fla. Atty. Conduct Reg. § 4-1.5(f)(4)(b).

Limits contingent fees in medical liability cases that settle before filing an answer or appointing an arbitrator to 33.3% of awards up to $1 million, 30% of awards between $1 million and $2 million, and 20% of awards exceeding $2 million.  Limits contingent fees in medical liability cases that do not settle before an answer is filed to 40% of awards up to $1 million, 30% of awards between $1 and $2 million, and 20% of awards exceeding $2 million.  Limits contingent fees in medical liability cases, where liability is admitted and only damages are contested, to 33.3% of awards up to $1 million, 20% of awards between $1 and $2 million, and 15% of awards exceeding $2 million.  Limits fees in medical liability cases that are appealed to an extra 5% of what is otherwise allowed.

Wisconsin
Medical Liability Reform: Collateral Source Rule Reform: Wisc. Stat. Ann. § 893.55 (7).

Allows for the admissibility of “evidence of any compensation for bodily injury received from sources other than the defendant to compensate the claimant.”

Washington
Medical Liability Reform: Contingent Fee Reform: Wash. Rev. Code Ann. § 7.70.070.

Requires a court to determine the reasonableness of contingent fees in medical liability cases.

Illinois
Medical Liability Reform: Contingent Fee Reform: 735 Ill. Comp. Stat Ann. § 5/2 –1114.

Limits contingent fees to 33.3% of the first $150,000 recovered, 25% of the next $850,000 recovered, and 20% of any amount recovered over $1 million.  The statute limiting the amount of contingent fees that attorneys representing medical liability plaintiffs may recover, but providing that court may review the fee agreement and approve a larger fee in an appropriate case, did not violate the access to courts provision of the State Constitution or equal protection, or due process provisions of the State or Federal Constitutions, and did not constitute prohibited special legislation.  Bernier v. Burris, 497 N.E.2d 763 (Ill. 1986).

Iowa
Medical Liability Reform: Collateral Source Rule Reform: Iowa Code Ann. § 147.136.

Provides for awards in medical liability cases to be offset by collateral sources.  The failure of the statute abrogating the collateral source rule in specified situations involving medical and hospital malpractice claims to distinguish between insured and self-insured institutions did not violate the equal protection clause of the Federal Constitution.  Lambert v. Sisters of Mercy Health Corp., 369 N.W.2d 417 (Iowa 1985).

Virginia
Medical Liability Reform: Damages Limits: Va. Code Ann. § 8.01-581-15.

Limits total damages in medical liability cases to $1.5 million for acts occurring on or after August 1, 1999, with additional annual adjustments of $50,000 on July 1, 2000, and each July 1 thereafter, with final annual increases of $75,000 on July 1, 2007, and July 1, 2008.  The $1 million limit on recoveries in medical liability actions did not violate the right to jury trial, prohibition against special legislation, or separation of powers provisions of the State Constitution, or takings, due process or equal protection provisions of the State or Federal Constitutions.  Pulliam v. Coastal Emergency Services of Richmond, Inc., 509 S.E.2d 307 (Va. 1999) (affirming Etheridge v. Medical Center Hospitals, 376 S.E.2d 525 (Va. 1989) (statutory limit on recoveries in medical malpractice actions did not violate due process, right to jury trial, separation of powers, prohibition against special legislation, or equal protection provisions of State Constitution).

Missouri
Medical Liability Reform: Noneconomic Damages Reform: Mo. Stat. § 538.210.

Limits noneconomic damages in medical liability cases to $350,000, to be increased or decreased on an annual basis in accordance with the Implicit Price Deflator for Personal Consumption Expenditures.  The $350,000 limit on noneconomic damages recoverable from any one defendant in a health care liability action did not violate equal protection clauses of the State or Federal Constitutions, or open courts or right to remedy provisions of State Constitution.  Adams v. Children’s Mercy Hospital, 832 S.W.2d 898 (Mo.), cert. denied, 506 U.S. 991 (1992).

West Virginia
Medical Liability Reform: Noneconomic Damages Reform: W.V. Code Ann. § 55-7B-8.

Limits noneconomic damages in medical liability cases to $1 million.  The $1 million limit on noneconomic damages awards in medical liability actions did not violate the equal protection, due process, or right to remedy provisions of the State Constitution.  Robinson v. Charleston Area Medical Center, Inc., 414 S.E.2d 877 (W.Va. 1991); Estate of Verba v. Ghaphery, 2001 WL 703840 (W. Va. June 19, 2001) (reaffirming Robinson decision).

Louisiana
Medical Liability Reform: Damages Reform: La. Rev. Stat. Ann. §40:1299.42.

Limits total damages in medical liability cases to $500,000, excluding future medical care.  The statute setting a $500,000 limit on general damages in medical liability cases did not violate the equal protection provisions of the State or Federal Constitutions.  Butler v. Flint Goodrich Hospital of Dillard University, 607 So. 2d 517 (La. 1989).

Constitutionality: Challenged and Upheld

Wisconsin
Medical Liability Reform: Noneconomic Damages Reform: AB 36 (1995): Wisc. Stat. Ann. §§ 893.55, 895.04.

Limits the award of noneconomic damages in medical liability cases to $350,000, indexed for inflation.  The $350,000 limit on noneconomic damages awards in medical liability cases did not violate the right to jury trial, separation of powers, remedy for wrongs, equal protection, or  due process provisions of the State constitution.  Guzman v. St. Francis Hospital, Inc., 2000 WL 1848463 (Wis. App. Dec. 19, 2000).

Colorado
Medical Liability Reform: Noneconomic Damages Reform: SB 143 (1988): Colo. Rev. Stat. § 13-64-302.

Limits the total award of damages to $1,000,000, of which no more than $250,000 can be for noneconomic damages.  The $250,000 limit on noneconomic damages in medical liability actions is constitutional.  Scholz v. Metropolitan Pathologists, P.C., No. 92‑8A277, Co. Sup. Ct., April 26, 1993.

California
Medical Liability Reform: Noneconomic Damages Reform: The Medical Injury Compensation Reform Act (MICRA): (1975): Cal. Civ. Code § 333.2.

Limits noneconomic damages in medical liability cases to $250,000.  The $250,000 limit on noneconomic damages in medical liability actions does not violate the equal protection or due process provisions of the State or Federal Constitutions.  Fein v. Permanente Medical Group, 695 P.2d 665 (Cal.), appeal dismissed, 474 U.S. 892 (1985).

Illinois
Medical Liability Reform: Contingent Fee Reform: 735 Ill. Comp. Stat Ann. § 5/2 –1114.

Limits contingent fees to 33.3% of the first $150,000 recovered, 25% of the next $850,000 recovered, and 20% of any amount recovered over $1 million.  The statute limiting the amount of contingent fees that attorneys representing medical liability plaintiffs may recover, but providing that court may review the fee agreement and approve a larger fee in an appropriate case, did not violate the access to courts provision of the State Constitution or equal protection, or due process provisions of the State or Federal Constitutions, and did not constitute prohibited special legislation.  Bernier v. Burris, 497 N.E.2d 763 (Ill. 1986).

Iowa
Medical Liability Reform: Collateral Source Rule Reform: Iowa Code Ann. § 147.136.

Provides for awards in medical liability cases to be offset by collateral sources.  The failure of the statute abrogating the collateral source rule in specified situations involving medical and hospital malpractice claims to distinguish between insured and self-insured institutions did not violate the equal protection clause of the Federal Constitution.  Lambert v. Sisters of Mercy Health Corp., 369 N.W.2d 417 (Iowa 1985).

Virginia
Medical Liability Reform: Damages Limits: Va. Code Ann. § 8.01-581-15.

Limits total damages in medical liability cases to $1.5 million for acts occurring on or after August 1, 1999, with additional annual adjustments of $50,000 on July 1, 2000, and each July 1 thereafter, with final annual increases of $75,000 on July 1, 2007, and July 1, 2008.  The $1 million limit on recoveries in medical liability actions did not violate the right to jury trial, prohibition against special legislation, or separation of powers provisions of the State Constitution, or takings, due process or equal protection provisions of the State or Federal Constitutions.  Pulliam v. Coastal Emergency Services of Richmond, Inc., 509 S.E.2d 307 (Va. 1999) (affirming Etheridge v. Medical Center Hospitals, 376 S.E.2d 525 (Va. 1989) (statutory limit on recoveries in medical malpractice actions did not violate due process, right to jury trial, separation of powers, prohibition against special legislation, or equal protection provisions of State Constitution).

Missouri
Medical Liability Reform: Noneconomic Damages Reform: Mo. Stat. § 538.210.

Limits noneconomic damages in medical liability cases to $350,000, to be increased or decreased on an annual basis in accordance with the Implicit Price Deflator for Personal Consumption Expenditures.  The $350,000 limit on noneconomic damages recoverable from any one defendant in a health care liability action did not violate equal protection clauses of the State or Federal Constitutions, or open courts or right to remedy provisions of State Constitution.  Adams v. Children’s Mercy Hospital, 832 S.W.2d 898 (Mo.), cert. denied, 506 U.S. 991 (1992).

West Virginia
Medical Liability Reform: Noneconomic Damages Reform: W.V. Code Ann. § 55-7B-8.

Limits noneconomic damages in medical liability cases to $1 million.  The $1 million limit on noneconomic damages awards in medical liability actions did not violate the equal protection, due process, or right to remedy provisions of the State Constitution.  Robinson v. Charleston Area Medical Center, Inc., 414 S.E.2d 877 (W.Va. 1991); Estate of Verba v. Ghaphery, 2001 WL 703840 (W. Va. June 19, 2001) (reaffirming Robinson decision).

Louisiana
Medical Liability Reform: Damages Reform: La. Rev. Stat. Ann. §40:1299.42.

Limits total damages in medical liability cases to $500,000, excluding future medical care.  The statute setting a $500,000 limit on general damages in medical liability cases did not violate the equal protection provisions of the State or Federal Constitutions.  Butler v. Flint Goodrich Hospital of Dillard University, 607 So. 2d 517 (La. 1989).

Constitutionality: Unchallenged

Alaska
Medical Apology: H.B. 250 (2014).

Makes an expression of apology, responsibility, liability, sympathy, commiseration, compassion or benevolence by a health care provider inadmissible in a medical liability case.  It also requires a health care provider to advise a patient to seek legal advice before making an agreement with the patient to correct an unanticipated outcome of medical treatment or care. 

 

Oklahoma
Medical Liability Reform: Expert Evidence: S.B. 6 (2013)

Adopts the federal rules of evidence.  Sets out that a qualified expert witness may testify on scientific, technical or other specialized knowledge if; (1) The testimony is based upon sufficient facts or data; (2) the testimony is the product of reliable principles and methods; and (3) the witness has applied the principles and methods reliably to the facts of the case.  Also sets out that facts or data that are otherwise inadmissible shall no tbe disclosed to the jury by the proponent of the opinion or inference unless the court determines that their probative value in assisting the jury to evaluate the expert’s opinion substantially outweighs their prejudicial effect.

Florida
Medical Liability Reform: Expert Evidence: H.B. 7015 (2013)

Provides that a witness qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion as to the facts at issue in a case under certain circumstances.  It requires the state to interpret and apply the principles of expert testimony in conformity with the United States Supreme Court’s decision in the Daubert case

Virginia
Medical Liability Reform: Expert Witness Certification: H.B. 1545 (2013)

States that in an action for medical liability, the court, upon showing good cause, may conduct an in camera review of the opinion obtained by the plaintiff of an expert witness who certified that the defendant deviated from the applicable standard of care and the deviation was the proximate cause of the injuries claimed.

Virginia
Medical Liability Reform: Expert Witness: S.B. 699

Requires the plaintiff, in medical liability cases, to provide certification of expert witnesses.  The plaintiff must disclose the identity and qualifications of the expert witness who certified that the defendant deviated from the applicable standard of care and the deviation was the proximate cause of the injuries claimed.  The certification is required before the plaintiff can commence any action for medical liability.

Pennsylvania
Medical Liability Reform: Benevolent Gestures: S.B. 379 (2013)

Allows health care providers to make benevolent gestures prior to the start of medical malpractice lawsuits, mediations, arbitrations or administrative actions and not have those statements or gestures of contrition used against them as long as such actions are not statements of negligence or fault.

Utah
Medical Liability Reform: Arbitration: H.B. 135 (2013)

Provides that a party in a medical liability action or arbitration may not attempt to allocate fault to any health care provider unless a certificate of compliance has been issued.  Also, requires that evidence from a medical review panel remain unreportable to a health care facility or health insurance plan.

Michigan
Medical Liability Reform: Noneconomic Damages Reform: S.B. 1115 (2012)

Classifies the loss of household or other services, loss of companionship and loss of consortium as noneconomic damages.  

Michigan
Medical Liability Reform: Prejudgment Interest Reform: S.B. 1118 (2012)

Ensures that a full 91-day period is given to defendants who submit an affidavit of meritorious defense and ends the practice of prejudgment interest being awarded on attorney fees and costs in medical liability cases. 

Rhode Island
Medical Liability Evidence Reform: H.B. 7559 (2012)

Expands the type of medical services and expense affidavits that can be introduced into evidence without the provider being required to testify in court.

North Carolina
Medical Liability Reform: Noneconomic Damages Reform: SB 33 (2011);N.C. Gen. Stat. § 90-21.19.

Limits noneconomic damages in medical liability cases to $500,000 against all defendants.  The limit is subject to adjustments, every three years starting on January 1, 2014, based on the Consumer Price Index.  The legislation does provide for an exception to the limit if: (1) the plaintiff suffered disfigurement, loss of use of part of the body, permanent injury or death; and (2) the defendant's acts or failures, which are the proximate cause of the plaintiff's injuries, were committed in reckless disregard of the rights of others, grossly negligent, fraudulent, intentional or with malice.

Alaska
Medical Liability Reform/Noneconomic Damages Reform: S.B. 67 (2005).

Lowers the limit on noneconomic damages in medical liability cases to $250,000.  In the most severe cases involving disfigurement, severe permanent physical impairment, and wrongful death, the limit on noneconomic damages is $400,000.  The previous limit on noneconomic damages ranged from $400,000 to $1 million, depending on the severity of the injuries.

South Carolina
Medical Liability Reform: Noneconomic Damages: S. 83 (2005).

Limits noneconomic damages in medical liability cases to $350,000 per provider, with an overall aggregate limit of $1.05 million. 

Missouri
Medical Liability Reform: Noneconomic Damages: H.B. 393 (2005).

Limits noneconomic damages in medical liability cases to a nonadjustable limit of $350,000 regardless of the number of defendants in the case.

South Carolina
Joint and Several Liability Reform: Medical Liability: S. 83 (2005).

Specifies that if there are multiple defendants in a civil action, joint and several liability does not apply to any defendant 50 percent or less responsible for the damages.  Furthermore, specified that comparative fault is included in the calculation of total fault in the case.  If the plaintiff is found to be greater than 50 percent responsible for the total fault, then the plaintiff is completely barred from recovering damages.  A defendant found to be less than 50 percent responsible is only responsible for its proportional share of damages based on its percentage of liability.  Retained the right of the “empty chair” defense where a defendant retains the right to assert that another potential tortfeasor, whether or not a party,  contributed to the alleged damages and may be liable for any or all damages alleged by another party.

Georgia
Medical Liability Reform/Noneconomic Damages Reform: S.B. 3 (2005).

Limits noneconomic damages to $350,000 per healthcare provider, with an overall aggregate limit of $1.05 million.

Illinois
Medical Liability Reform: Noneconomic Damages Reform: SB 475 (2005).

Limits noneconomic damages in medical liability cases to $500,000 per physician and $1 million per hospital.

Mississippi
Medical Liability Reform: Noneconomic Damages Reform: H.B. 13 (special session) (2004); Amended Miss. Code Ann. § 11-1-60.

Establishes a hard cap of $500,000 on noneconomic damages in medical liability cases (the $500,000 cap that was passed during a special session in 2002 contained an escalator clause which would have raised the cap to $750,000 in 2011 and $1 million in 2017).

Oklahoma
Medical Liability Reform: Noneconomic Damages: H.B. 2661 (2004).

Extends the sunset provision on the limit on noneconomic damages for ob/gyn’s and emergency care situations (S.B. 629, 2003) from July 1, 2008 until November 1, 2010.

Oklahoma
Medical Liability Reform: Noneconomic Damages: SB 629 (2003): 63 O.S. § 1-1708.1F.

Limits the award of noneconomic damages to $350,000 in cases involving pregnancy (labor, delivery, and post partum period) as well as emergency care.

Colorado
Medical Liability Reform: Noneconomic Damages Reform: HB 03-1007 (2003).

Limits noneconomic damages in medical malpractice cases to $300,000.

Texas
Medical Liability Reform: Noneconomic Damages Reform: HB 4 (2003).

Limits the award of noneconomic damages in medical malpractice cases to $250,000 against all doctors and health care practitioners and a $250,000 per-facility cap against health care facilities such as hospitals and nursing homes, with an overall cap of $500,000 against health care facilities, creating in effect an overall limit of noneconomic damages in medical malpractice cases of $750,000.

Florida
Medical Liability Reform: Noneconomic Damages Reform: CS SB 2-D (special session 2003).

Provides for emergency room practitioner limits on noneconomic damages of $150,000 per claimant, with an aggregate of $300,000.  Provides for emergency room facility limits on noneconomic damages of $750,000 per claimant, with an aggregate of $1.5 million and full setoffs for practitioner payments.  Provides for non-practitioner limits on noneconomic damages of $750,000 per claimant, with an aggregate for all claimants.  Provides for practitioner limits on noneconomic damages of $500,000 per claimant, with an aggregate limit for all claimants of $1 million, but no single practitioner shall be liable for more than $500,000 regardless of the number of claimants.

West Virginia
Medical Liability Reform: Noneconomic Damages Reform: HB 2122 (2003): W.V. Code Ann. § 55-7B-8.

Limits the award of noneconomic damages in medical malpractice cases to $250,000 to $500,000 depending on the severity of the injuries.

Ohio
Medical Liability Reform: Noneconomic Damages: SB 281 (2003); ORC Ann. 2323.43.

Limits the award of noneconomic damages in medical liability cases to $350,000, with a provision to allow the cap to rise to $1 million, depending on the severity of the injuries and the number of plaintiffs involved in the suit.

Mississippi
Medical Liability Reform: Noneconomic Damages Reform: H.B.2 (special session) (2002); Amended Miss. Code Ann. § 85-5-7.

Limits noneconomic damages to $500,000 until July 1, 2011, $750,000 from July 1, 2011 until July 1, 2017, and $1 million after July 1, 2017, not adjusted for inflation, unless a judge were to determine that a jury could impose punitive damages. Prohibits the disclosure to a jury of the noneconomic damages limit.

Mississippi
Medical Liability Reform: Joint and Several Liability Reform: H.B.2 (special session) (2002); Amended Miss. Code Ann. § 85-5-7.

Replaces the rule of joint and several liability with the rule of proportionate liability for noneconomic damages (that is, limit a joint tortfeasor’s liability for noneconomic damages to his percentage of fault).  Replaces the rule of joint and several liability with the rule of proportionate liability for economic damages, where the defendant is found to be less than 30% at fault.  Replaces the rule of joint and several liability with a rule that allows a joint tortfeasor to be held up to 50% responsible for economic damages, where the defendant is found to be at least 30% at fault.

Pennsylvania
Medical Liability Reform: Collateral Source Rule Reform: HB 1802 (2002): 40 Pa. Cons. Stat. Ann. § 1301.602.

Prohibits a patient from suing for damages that were paid by a health insurer.

Nevada
Medical Liability Reform: Emergency Room Liability: AB 1 (2002).

Limits damages in medical liability cases against emergency room physicians to $50,000.

Nevada
Medical Liability Reform: Noneconomic Damages Reform: AB 1 (2002).

Limits noneconomic damages in medical liability cases to $350,000, except upon a showing of “gross malpractice” or a judicial determination that there is “clear and convincing evidence” that the noneconomic award should exceed the cap. 

Florida
Medical Liability Reform: Nursing Homes: Punitive Damages: SB 1202 (2001).

Requires a plaintiff to prove punitive damages by clear and convincing evidence in cases against nursing home facilities.  Limits punitive damages against nursing home facilities to the greater of three times the award of compensatory damages or $1 million.  Limits punitive damages against nursing home facilities to the greater of $4 million or four times the award of compensatory damages, where conduct is proven to be motivated by financial gain.  Sets no limit on the award of punitive damages against nursing home facilities, where intentional harm is proven. 

Montana
Medical Liability Reform: Noneconomic Damages Reform: HB 309 (1995): Mont. Code Ann. § 25‑9‑411.

Limits the award of noneconomic damages in medical malpractice cases to $250,000. 

Michigan
Medical Liability Reform: Noneconomic Damages: SB 270/H 2 (1993): Mich. Comp. Laws § 600.1483.

Limits the award of noneconomic damages in medical liability cases to $280,000 for ordinary occurrences, and $500,000 if the claimant has suffered brain damage, spinal cord damage, damage to the reproductive system which prevents procreation, or injury to cognitive ability that leaves the plaintiff unable to live alone.

Colorado
Medical Liability Reform: Punitive Damages: HB 1069 (1990).

Provides that punitive damages shall not be alleged in a professional negligence suit until discovery is substantially completed. Provides that discovery cannot be reopened without an amended pleading. Provides that physicians cannot be held liable for punitive damages because of the bad outcome of a prescription medication as long as it was administered in compliance with current FDA protocols.  Prohibits punitive damages from being assessed against physicians because of the act of another unless he directed the act or ratified it.

Florida
Medical Liability Reform: Noneconomic Damages: CS/SB6 (1988): Fla. Stat. §§ 766.207, 766.209.

Limits noneconomic damages in medical liability cases to $250,000 in arbitration.  Limits noneconomic damages in medical liability cases to $350,000, if the plaintiff refuses to arbitrate.  Sets no limit on noneconomic damages in medical liability cases, where neither party demands binding arbitration, or where the defendant refuses to arbitrate.

Alabama
Medical Liability Reform: Wrongful Death: (1987).

Limits damages in wrongful death actions to $1 million.

California
Medical Liability Reform: Contingent Fee Reform: The Medical Injury Compensation Reform Act (MICRA): (1975): Cal. Bus. & Prof. Code § 6146(a).

Limits contingent fees in medical liability cases to 40% of the first $50,000 recovered, 33.3% of the next $50,000, and 15% of any amount exceeding $600,000.

Wisconsin
Medical Liability Reform: Contingent Fee Reform: Wisc. Stat. Ann. § 655.013.

Limits contingent fees to 1/3 of the first $1 million recovered, 25% of the first $1 million recovered if liability is stipulated within 180 days of filing of the original complaint and not within 60 days of first day of trial, and 20% for amounts exceeding $1 million recovered.  Allows a judge to exceed these amounts in exceptional circumstances.

Hawaii
Medical Liability Reform: Contingent Fee Reform: Haw. Rev. Stat. § 607-15.5.

Limits contingent fees in medical liability cases to a “reasonable amount,” as determined by the court.

Wyoming
Medical Liability Reform: Contingent Fee Reform: Wyo. Ct. Rules Ann. Contingency Fee R. 5.

Limits contingent fees in medical liability cases to: one-third of the recovery, if the claim settles within 60 days of the filing of the lawsuit; forty percent of the recovery, if the claim is settled after 60 days or a judgment is entered upon a verdict; and 30 percent of any recovery exceeding $1 million.

Massachusetts
Medical Liability Reform: Noneconomic Damages Reform: Mass. Gen. Laws Ann. Ch. 231 § 60-H.

Limits noneconomic damages in medical liability cases to $500,000, unless the claimant can show "a substantial or permanent loss or impairment of a bodily function or substantial disfigurement."

Indiana
Medical Liability Reform: Contingent Fee Reform: Ind. Code Ann. § 34-18-18-1.

Limits contingent fees in medical liability cases to 15% of the recovery that comes from the Patient’s Compensation Fund.  

South Dakota
Medical Liability Reform: Noneconomic Damages Reform: S.D. Codified Laws § 21-3-11.

Limits noneconomic damages in medical liability cases to $500,000.

Michigan
Medical Liability Reform: Collateral Source Rule Reform: Mich. Comp. Laws § 600.6303.

Provides for medical liability awards to be offset by collateral sources, less any premiums paid to obtain the benefit. 

Iowa
Medical Liability Reform: Contingent Fee Reform: Iowa Code Ann. § 147.138.

Provides that a court in medical liability cases “shall determine” the reasonableness of the contingency fee. 

Montana
Medical Liability Reform: Collateral Source Rule Reform: Mont. Code Ann. § 27‑1‑308.

Provides for awards to be offset by collateral sources that do not involve rights of subrogation in medical liability cases for awards over $50,000.

Maine
Medical Liability Reform: Contingent Fee Reform: Me. Rev. Stat. Ann. tit. 24 § 2961.

Limits contingent fees in professional liability cases to 33.3% of the first $100,000 recovered, 25% of the next $100,000 recovered, and 20% of any amount recovered over $2 million.  Permits a judge to allow fees in excess of these amounts in special circumstances.

Delaware
Medical Liability Reform: Collateral Source Reform: Del. Code Ann. tit. 18 § 6862.

Permits the admissibility of evidence of collateral source payments in medical liability actions.

Nebraska
Medical Liability Reform: Collateral Source Rule Reform: Neb Stat. § 44-2819.

Allows evidence of nonreturnable medical reimbursement insurance in medical liability cases to be taken as a credit against any judgment rendered.

Massachusetts
Medical Liability Reform: Contingent Fee Reform: Mass. Gen. Laws Ann. Ch. 231 § 60-I.

Limits contingent fees in medical liability cases to 40% of the first $150,000 recovered, 33.3% of the next $150,000 recovered, 30% of the next $200,000 recovered, and 25% of any amount over $500,000 recovered.

Utah
Medical Liability Reform: Noneconomic Damages Reform: Utah Code Ann. § 78-14-7.1.

Limits noneconomic damages in medical liability cases to $250,000.

Nevada
Medical Liability Reform: Collateral Source Rule Reform: Nev. Rev. Stat. Ann. § 42.020.

Provides for awards in medical liability cases to be offset by the amount received by a collateral source, including any prior payment by the defendant health care provider.  

Michigan
Medical Liability Reform: Contingent Fee Reform: Mich. Ct. R. 8.121.

Limits contingent fees in medical liability cases for personal injury or death to 33.3% of the amount recovered.

Minnesota
Medical Liability Reform: Contingent Fee Reform: Minn. Stat. Ann. § 548.36.

Requires that contingent fees in medical liability cases be based on the award adjusted for collateral source benefits.

Alaska
Medical Liability Reform: Contingent Fee Reform: Alaska Stat. § 9.60.080.

Requires that contingent fees be calculated exclusive of punitive damages.

New York
Medical Liability Reform: Collateral Source Rule Reform: N.Y. C.P.L:R § 4545(a).

Permits the admissibility of evidence of collateral source payments in medical liability cases.

Nebraska
Medical Liability Reform: Contingent Fee Reform: Neb Stat. § 44-2834.

Allows a court to review contingent fees in medical and professional liability cases.

New Hampshire
Medical Liability Reform: Contingent Fee Reform: N.H. Rev. Stat. Ann. § 508:4-e.

Requires a court to approve contingent fees exceeding $200,000 in medical liability cases.

Indiana
Medical Liability Reform: Damages Limits: Ind. Code Ann. § 34-18-14-3.

Limits the total amount recoverable in medical liability cases to $750,000 for acts that occur before July 1, 1999, and $1,250,000 for acts that occur after July 1, 1999.  Requires any amount awarded in excess of these limits to be paid from the Patient’s Compensation Fund.

Rhode Island
Medical Liability Reform: Collateral Source Rule Reform: R.I. Gen. Laws § 9-19-34.1.

Permits the admissibility of evidence collateral source payments from “state income disability or workers’ compensation, any health, sickness or income disability policy, or other contracts” for reimbursement.  Requires a jury to reduce damages awards by the amount paid by collateral sources, if such evidence is introduced.

New Jersey
Medical Liability Reform: Contingent Fee Reform: N.J. Ct. R. § 1:21-7.

Limits contingent fees in medical liability cases pursuant to a sliding scale provided in the New Jersey Court Rules.

Wisconsin
Medical Liability Reform: Wrongful Death Damages Reform: Wisc. Stat. Ann. §§ 893.55, 895.04.

Limits damages in wrongful death cases to $500,000 for a minor and $350,000 for an adult.

Arizona
Medical Liability Reform: Contingent Fee Reform: Ariz. Rev. Stat. § 12-568.

Allows a court to consider the reasonableness of attorneys’ fees in medical liability cases, taking into account factors such as “the time and labor required, the novelty and difficulty of the questions involved, and the skill requisite to perform the legal skills properly.”

South Dakota
Medical Liability Reform: Collateral Source Rule Reform: S.D. Codified Laws § 21-3-12.

Permits the admissibility of evidence of collateral source payments when the claimant alleges special damages that are or will be paid by insurance, are not subject to subrogation, and are not purchased privately or by government programs. 

New York
Medical Liability Reform: Contingent Fee Reform: N.Y. Jud. Law § 474-a.

Limits contingent fees in medical liability cases by a sliding scale.

Maine
Medical Liability Reform: Noneconomic Damages Reform: Me. Rev. Stat. Ann. tit. 24-A § 4313.

Limits noneconomic damages against a carrier of a health plan to $400,000.

Tennessee
Medical Liability Reform: Collateral Source Reform: Tenn. Code Ann. § 29-26-119.

Provides for economic damages to be offset in medical liability cases by collateral sources, except for sources including the assets of the plaintiff and the immediate family, or insurance purchased by the plaintiff in whole or in part. 

New Mexico
Medical Liability Reform: Damages Limits: N.M. Stat. Ann. § 41-5-6, 41-5-7.

Limits total damages in medical liability cases to $600,000, except for punitive damages and medical care and related benefits.

Oklahoma
Medical Liability Reform: Contingent Fee Reform: Okla. Stat. Ann. tit.5, § 7.

Limits contingent fees to 50% of a plaintiff’s recovery.

Connecticut
Medical Liability Reform: Contingent Fee Reform: Conn. Gen. Stat. Ann. § 52‑251c.

Limits contingent fees in medical liability cases to 33.3 % of the first $300,000 recovered, 25% of the next $300,000, 20% of the next $300,000, 15% of the next $300,000, and 10% of any amount exceeding $1.2 million.

Utah
Medical Liability Reform: Collateral Source Rule Reform: Utah Code Ann. § 78-14-4.5.

Provides for awards to be offset by collateral source payments, excluding any source for which a subrogation right exists and any amount paid by plaintiff or the immediate family to secure the benefit.

Tennessee
Medical Liability Reform: Contingent Fee Reform: Tenn. Code Ann. § 29-26-120.

Requires a judge to award contingent fees in medical liability cases not to exceed 33.3%.

Delaware
Medical Liability Reform: Contingent Fee Reform: Del. Code Ann. tit. 18 § 6865.

Limits contingent fees in medical liability cases to 35% of the first $100,000 recovered, 25% of the next $100,000, and 10% of the balance.

Washington
Medical Liability Reform: Collateral Source Rule Reform: Wash. Rev. Code Ann. § 7.70.080.

Permits the admissibility of evidence of collateral source payments in medical liability cases, except if the source is an insurance policy that the plaintiff or a member of the immediate family purchased with his or her assets.

Utah
Medical Liability Reform: Contingent Fee Reform: Utah Code Ann. § 78-14-7.5.

Limits contingent fees in medical liability cases to 1/3 of the amount recovered.

Florida
Medical Liability Reform: Contingent Fee Reform: Fla. Atty. Conduct Reg. § 4-1.5(f)(4)(b).

Limits contingent fees in medical liability cases that settle before filing an answer or appointing an arbitrator to 33.3% of awards up to $1 million, 30% of awards between $1 million and $2 million, and 20% of awards exceeding $2 million.  Limits contingent fees in medical liability cases that do not settle before an answer is filed to 40% of awards up to $1 million, 30% of awards between $1 and $2 million, and 20% of awards exceeding $2 million.  Limits contingent fees in medical liability cases, where liability is admitted and only damages are contested, to 33.3% of awards up to $1 million, 20% of awards between $1 and $2 million, and 15% of awards exceeding $2 million.  Limits fees in medical liability cases that are appealed to an extra 5% of what is otherwise allowed.

Wisconsin
Medical Liability Reform: Collateral Source Rule Reform: Wisc. Stat. Ann. § 893.55 (7).

Allows for the admissibility of “evidence of any compensation for bodily injury received from sources other than the defendant to compensate the claimant.”

Washington
Medical Liability Reform: Contingent Fee Reform: Wash. Rev. Code Ann. § 7.70.070.

Requires a court to determine the reasonableness of contingent fees in medical liability cases.

Constitutionality: Challenged and Struckdown

New Hampshire
Medical Liability Reform: Noneconomic Damages Reform:

A New Hampshire law setting a $250,000 limit on noneconomic damages in medical liability cases was held unconstitutional in Carson v. Maurer, 424 A.2d 825 (N.H. 1980). A $875,000 cap on noneconomic damages was held unconstitutional in Brannigan v. Usitalso, 587 A.2d 1232 (N.H. 1980)). 

Texas
Medical Liability Reform: Wrongful Death: Tex. Rev. Civ. Stat. art. 4590i § 11.02.

Limits damages in wrongful death actions to $500,000. The statute originally limited damages in all negligence actions, but the Texas Supreme Court held it unconstitutional except as to wrongful death actions in Rose v. Doctors Hospital, 801 S.W.2d 841 (Tex. 1990)  .

New Hampshire
Medical Liability Reform: Collateral Source Rule Reform.

A New Hampshire statute abolishing the collateral source rule was found to be unconstitutional in Carson v. Maurer, 424 A.2d 825 (N.H. 1980).