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MALPRACTICE REFORMS CLEAR HOUSE PANEL

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WASHINGTON-Medical malpractice reform advocates are looking to a Medicare funding bill as a means to provide broad-ranging liability relief for medical practitioners.

The measure, which enjoys bipartisan support in the House, won the approval of the Ways & Means Committee last week. The liability reforms are part of a series of initiatives designed to keep Medicare solvent for at least another decade.

But in spite of the broad House support for the reform measure, the head of a coalition of medical providers, insurance companies and other reform backers warns that the going could be rougher in the Senate.

The measure would set uniform standards for health care liability actions regardless of whether Medicare payments are involved or not. Under the bill-put together by Rep. Bill Thomas, R-Calif., and chairman of the House Ways and Means Committee's Health Subcommittee-non-economic damages in medical malpractice cases would be limited to $250,000, regardless of the number of defendants named in the case.

In addition, the proposed reforms would make defendants liable only for their proportion of damages rather than jointly and severally liable for any damages awarded.

The measure would also limit punitive damages in medical malpractice cases to the greater of three times economic loss or $250,000.

Punitive damages could not be awarded against manufacturers or sellers of medical devices that had received premarket approval from the Food and Drug Admin-istration under most circumstances.

The reform measure also would require:

Structured settlements when combined economic and non-economic damages exceed $50,000.

An absolute statute of limitations of five years for bringing medical liability actions.

A prohibition on double recovery by reforming collateral source rules.

Promotion of the use of alternative dispute resolution mechanisms.

Wayne Sinclair, chairman of the executive committee of the Washington-based Health Care Liability Alliance, said the proposed medical malpractice liability reforms are necessary "to bring some sense to the lottery mentality" surrounding medical malpractice awards.

"As health care costs rise and the insurance market continues to be not the most stable in the world due to uncertainty in medical malpractice market, we're trying to level the playing field," he said.

"At some point I think it's going to happen," Mr. Sinclair said.

"Our problem right now is the Senate," he said. If the reforms can be kept in budget reconciliation legislation, only 51 votes will be needed to approve them. But as a stand-alone measure, the liability reforms would have to draw the support of at least 60 senators to invoke cloture-an end to debate-and bring the matter to a vote.

In addition, even if reforms pass both houses, the measure would still be the subject of negotiations with the White House, which has taken a generally skeptical view of uniform liability codes of any kind.