When President Barack Obama held the bipartisan summit on health care reform in February, one of the issues raised by Sen. Tom Coburn (R-OK) was a need for more efforts in tort reform, particularly in medical malpractice. Tort reform proponents have often argued that medical malpractice litigation has lead to costly "defensive medicine" and higher insurance liability premiums. Obama supported reform.

The Patient Protection and Affordable Care Act (PPACA) has measures to address medical liability. The Department of Health and Human Services (HHS) will award five-year demonstration grants to states for the development, implementation, and evaluation of alternatives to litigation. Fifty million dollars will be authorized for this initiative.

The grants are for state programs that have resolution for patients who have been allegedly injured by health care providers or organizations, while also promoting reduction of health care errors through collecting and analyzing data on patient safety.

The states that apply for the grants will need to demonstrate how a proposed alternative will make the medical liability system more reliable by increasing the availability of prompt and fair resolution of disputes. This includes:

--Encouraging efficient resolution of disputes;

--Encouraging disclosure of health care errors;

--Enhancing patient safety by detecting, analyzing, and helping to reduce medical errors and adverse events;

--Improving access to liability insurance;

--Fully informing patients about the differences in the alternative and current tort litigation;

--Giving patients the ability to opt out of or voluntarily withdraw from participating in the alternative at any time and to pursue other options;

--Not limiting or curtailing a patient's existing legal rights.

The state must also disclose the sources to fund compensation for any claims resolved under the proposed alternative, whether public or private. Funding should provide financial incentives for activities that improve patient safety.

HHS will give preference to states that have developed a proposed alternative after consultation with relevant stakeholders (patient advocates, health care providers and health care organizations, attorneys with expertise in representing patients or health care professionals, medical malpractice insurers, and patient safety experts). In addition, states that offer proposals for patient safety and reduced medical errors will receive preference in grants.

The states that receive grants will submit an annual report to HHS evaluating the effectiveness of the programs on patient safety and availability, and price of medical liability insurance. HHS will also conduct a study of the overall evaluation of the effectiveness of the grants for Congress.

The HHS evaluations will analyze and compare program information on:

--Statistics on injuries allegedly caused by health care providers or health care organizations;

--Statistics on claims in which tort litigation was pursued despite the existence of an alternative program;

--Patient safety and medical errors/adverse events;

--Patient and health care provider and organization satisfaction with the alternative and with the medical liability environment;

--Impact on utilization of medical services.

The PPACA has also extended medical liability coverage to free clinics.

OTHER REFORM NEWS

In other health reform news, President Obama recently held a speech at the American Nurses Association. He thanked the organization for supporting health care reform and described measures that would benefit the primary care workforce, such as funding for students training part-time to become nurse practitioners to start training full-time, and providing resources for clinics run by registered nurses and nurse practitioners.

Also this week, Obama praised the new Patients' Bill of Rights under the PPACA.

The President's remarks can be accessed at: http://www.whitehouse.gov/the-press-office/remarks-president-american-nurses-association

http://www.whitehouse.gov/the-press-office/remarks-president-affordable-care-act-and-new-patients-bill-rights