Dr. Gabrielle Adams of Southwest Gastroenterology and Southwest Endoscopy is seen entering a treatment room on December 7, 2021. (Adolphe Pierre-Louis / )
Copyright © 2021
SANTA FE – A group of independent doctors and medical practices say they are preparing to close their offices or cut back on December 31st unless New Mexico revises its new medical malpractice law – a development that will address the chronic shortage to health care providers in the state.
The group suggests revisions that they say they would clarify the law to respond to questions from their insurance carriers rather than making sweeping changes.
Governor Michelle Lujan Grisham and state lawmakers are now weighing the request for emergency measures. A special session began this week providing an opportunity to revise the law if policy makers are convinced that change is needed and ready to act quickly.
The focus of the debate is the Medical Liability Act, which was revised at the beginning of the year as part of delicate negotiations between hospitals, healthcare providers, litigators and patients. Much of the law comes into force on January 1st.
However, doctors at Southwest Gastroenterology and Southwest Endoscopy – along with other medical practices – say the details of the law could have unintended effects.
The concern is centered on definitions that determine who is subject to a $ 4 million limit for malpractice harm and who is subject to a limit of $ 750,000 in the healthcare system.
The larger upper limit was generally intended for large hospitals, while the lower limit was intended for independent doctors who are not employees of a hospital.
But insurance carriers have raised questions about how to deal with general practitioners, who sometimes work in hospitals or own and operate their own small clinics.
Dr. Gabrielle Adams, of Southwest Gastroenterology, said her practice should close in a few weeks and relocate tens of thousands of patients because she is unable to get the necessary $ 4 million insurance cover unless the law is cleared .
“There is no other GI practice that can take in the patients that we have,” Adams said in an interview.
Executives at X-Ray Associates of New Mexico and New Mexico Orthopedics – both of whom employ independent doctors – said their surgeons may not be able to work in hospitals without technical changes in law.
“I don’t think it can wait,” said Jeffrey Racca, surgeon of New Mexico Orthopedics, of the need for change.
The new Medical Liability Act was passed at the beginning of the year during the regular 60-day legislative period. Two competing proposals sparked heated debates, including heartbreaking statements from families harmed by medical misconduct.
But a coalition of doctors, litigators, and others eventually reached a compromise to break the impasse and gain legislature approval for law updates.
Kathy Love, an Albuquerque attorney and former president of the New Mexico Trial Lawyers Association, said those involved are already moving towards another agreement to address new insurance concerns.
She described the updates as technical in nature.
“We all know we need these facilities,” said Love, “and we need them to be covered when patients get injured there.”
Ezra Spitzer, a lawyer whose testimony about his daughter Effie’s death played a role in passing this year’s bill, said the updates now being discussed were simply in line with the intent of the earlier compromise.
“It’s a complicated act,” he said, “and there is a technical solution.”
Love said the parties are nearing an agreement but it is premature to discuss details.
Doctors also sounded optimistic about a deal.
In a written statement, Annie Jung, executive director of the New Mexico Medical Society, “thanked the litigators, insurance providers, and other stakeholders for their openness and willingness to find a cure so that New Mexico can continue to receive the medical care they have.” . need, continuously. “
The parties are under deadline pressure, especially when legislative approval is required.
Lujan Grisham spokeswoman Nora Meyers Sackett said the government was meeting with the parties and would take action if necessary.
“In these discussions it became clear that there was at least a need to be clear about what the legislature has brought about in the reform of the Medical Malpractice Act,” said Sackett.
Lujan Grisham’s approval – through an executive message – is required to put legislative proposals on the agenda of the special session.
Lujan Grisham prefers a deal that doesn’t require legislative action, Sackett said.
Questions about damage limits
The complex law passed earlier this year was designed to ensure that healthcare providers can afford insurance cover and that patients suffering catastrophic injuries can be brought to justice at the same time.
Two new damage caps have been created – one of $ 4 million for hospitals and $ 750,000 for independent doctors. The old limit was around $ 600,000 for certain damage. Some of the legal questions raised by the insurance carriers now revolve around the question of whether independent doctors, some of whom work in hospitals, should be subject to the higher limit as “agents” of the hospital. There are also questions about how to deal with small outpatient clinics operated by general practitioners.
Senator Gay Kernan, R-Hobbs, said she hoped the trial lawyers and doctors could come to an agreement quickly on clearing the medical malpractice law.
“It is absolutely critical that everyone realizes that this is a real crisis,” said Kernan.
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