Articles Posted in Legislation

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This blog entry comes courtesy of the President of the Illinois Trial Lawyers Association and was published in the February 24, 2011 edition of the Belleville News Democrat:

It is once again time to set the record straight with your editorial board. There was never a health care crisis in this state and there were no “jackpot justice conditions” that caused doctors to flee Illinois.

Your editorial board and the president of the Illinois State Medical Society (ISMS) have chosen to ignore important facts when it comes to medical care access in this state. Over the years, we have consistently increased the number of physicians in our state. That’s right. The American Medical Association data reflects increases for each of the last 45 years. Clearly not a climate of doctors leaving Illinois or retiring early.

Funny how it used to be, for years, ISMS would falsely claim doctors were fleeing our state and that we already had a shortage of doctors because of fabricated “jackpot justice conditions.” As the data has failed to support that claim, the dialogue now shifts to an attempt to create a “future crisis”. In fact, a recent survey – funded in part by ISMS – clearly demonstrated oversaturation of physicians in the largest populated area of our state. That’s correct – more than enough doctors in the greater Chicagoland area.

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The Deficit Reduction Act of 2005 (DRA) overhauled Medicare’s perspective on payment for medical care related to “never events” including a list of delineated hospital acquired conditions. Hospitals will no longer receive reimbursement for conditions that are (a) high cost or high volume or both, (b) result in the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been prevented through the application of evidence-based guidelines. The ten categories for hospital acquired conditions are: Foreign Object Retained After Surgery,.Air Embolism,,Blood Incompatibility, Stage III and IV Pressure Ulcers, Falls and Trauma including, Fractures, Dislocations, Intracranial Injuries, Crushing Injuries, Burns and Electric Shock, Manifestations of Poor Glycemic Control including, Diabetic Ketoacidosis, Nonketotic Hyperosmolar Coma, Hypoglycemic Coma, Secondary Diabetes with Ketoacidosis and Secondary Diabetes with Hyperosmolarity, Catheter-Associated Urinary Tract Infection, Vascular Catheter-Associated Infection, Surgical Site Infection Following Coronary Artery Bypass Graft (CABG) – Mediastinitis, Bariatric Surgery, Laparoscopic Gastric Bypass, Gastroenterostomy, Laparoscopic Gastric Restrictive Surgery, Orthopedic Procedures and Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE).

While the Centers for Medicare and Medicaid Services (CMS) have prohibited hospitals from recovering payment for the treatment of secondary conditions acquired in the hospital, practically, these charges are often submitted and paid by Medicare long before and attorney becomes involved and makes a claim for medical malpractice. Careful examination of the supporting documentation Medicare provides at the time they require reimbursement often reveals that benefits were paid for hospital acquired events.

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Fact: Did you know independent authoritative studies have shown that medical malpractice claims have little effect on overall health care costs?

• Malpractice claims boost overall health care costs no more than a tiny percentage according to the Congressional Budget Office.

• The Congressional Budget Office has also concluded that the most anti-patient medical malpractice “reforms” may lead to poorer health care and worse patient outcomes.

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The Illinois Supreme Court in a 4-2 decision struck down limits on damages awards in medical malpractice cases with its decision in Lebron v. Gottlieb Memorial Hospital on thursday. The court held that the legislation was unconstitutional. The majority opinion, authored by Justice Fitzgeral held, in part: “[W]e necessarily consider…the legislature’s goal in enacting the statue-responding to a health-care crisis. Our separation of powers analysis, however, does not stop there. The crux of our analysis is whether the statue unduly infringes upon the inherent power of the judiciary. Here, the legislature’s attempt to limit…damages in medical malpractice actions runs afoul of the separation of powers clause.”

This is a major victory for patients and consumers in Illinois. The legislature has tried, on three seperate occasions, to enact caps on damages in medical malpractice cases. For years lobbiests for the insurance industry have argued that medical malpractice awards have contributed to the high cost of health care in Illinois despite the fact that insurace payouts on these claims have remained level for the past two decades.

All citizens of Illinois should have a right to ask a jury of their peers for redress when they have been victimized by negligence, regardless of the profession of the guilty party. To see a copy of the Supreme Courts landmark opinion look here.

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Earlier this week the Illinois Supreme Court announced that it would likely release its decision on medical malpractice reform in the case of Lebron, et al vs. Gottlieb Memorial Hospital, et al today.

Unfortunately, it appears that the court did not release the decision today as anticipated. This is not an uncommon occurence. The Lebron case was argued before the court over one year ago and the supreme’s decision is much anticipated by the trial bar and general public.

The Medical Malpractice Reform Act of 2005 was determined to be unconstitutional by Judge Diane Larsen of the Circuit Court of Cook County. Her ruling determined that caps on damages in medical malpractice cases are not allowed by the state constitution, something that the Illinois Supreme Court has decided on two prior occasions.

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In the wake of the devastating three part series in this week’s Chicago Tribune exposing Chicago and Illinois nursing homes and their practice of housing sex offenders and convicted felons with regular patients, Patrick Quinn, the Governor of Illinois, has announced the formation of a high level task force to look into these troubling issues.

The goal of the task force is to find safe ways to house those nursing home patients suffering from mental illness. The Tribune report exposed several shocking cases of nursing home abuse and neglect where residents were assaulted and/or raped by mentally ill criminals being housed in area nursing homes.

The Chicago Tribune has developed a website which will allows the public to track convicted felons and sex offenders residing in Chicago and Illinois nursing homes.

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In Illinois there is a stautue of limitations on medical malpractice claims which generally prohibits filing of a lawsuit two years from the date of malpractice or two years after the malpractice is discoverd. The statute of repose sets an outside tail date for filing such claims after four years have elapsed from the time of the initial malpractice. There are certain exceptions to this general statute of limitiations. At Goldberg & Goldberg we are proud of our work to help protect the rights of brain injured children. As an example of such work we are proud to say that due to our tireless efforts to fight for and protect brain injured children, including those suffering from cerebral palsy, the Illinois Supreme Court extended the statute of limitations for minors suffering from a brain injury indefinitely.

In Bruso v. Alexian Brothers Hospital, 178 Ill. 2d 445, 453 (1997), the Illinois Supreme Court, in an opinion authored by Justice Michael Bilandic held, that a minor who is under another legal disability, such as a brain injury, shall have the statute of limitations tolled on his claim until said legal disability is lifted. As a result, brain injured persons are protected from the statute of limitations until such a time as their disability no longer exists. This is a significant victory for consumers in Chicago, and throughout Illinois.

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A study prepared by the Chicago Reporter shows that black Chicago area nursing home residents receive the worst quality care in the country. There is just one nursing home in the Chicago area rated excellent by the federal government where the majority of the patients are black. These homes have more federal violations, medical malpractice and personal injury claims against them then majority white nursing homes.

The Reporter analyzed records from over 15,000 nursing homes nationwide in order to determine whether disparities exist in the quality of care based on a variety of factors, including race. The Reporter found that the worst rating was given to 57% of Chicago area nursing homes where the patient population was majority black.

Nursing homes have to comply with a variety of state and federal regulations that govern the quality of care required of their patients. There is a particular need to regulate nursing homes as they are usually operated as a for profit business and the patients are typically infirm and/or elderly. In 1987 the federal government passed The Omnibus Budget Reconcilliation Act which outlined the rights of nursing home patients, including the right to be properly evaluated at the time of admission and regularly thereafter as well as the right to have a doctor care for them.

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What does reforming medical malpractice have to do with the current health care reform debate that is a hot topic in Washington and here in Illinois? Not much, at least according to one ranking United States Senator.

“I honestly really don’t see this as a health care issue,” said Sen. Sheldon Whitehouse (D-R.I.). The Senator, a former Rhode Island attorney general, argues that medical malpractice is more of an “intruder” into the debate to protect insurance companies, hospitals and doctors from being accountable for their mistakes.

There is very little objective evidence that malpractice reforms, like capping damages awards, have any impact on health care costs. California, which has had caps on medical malpractice awards for more then thirty years, has not seen health care costs reduced over that time period. The argument that doctors are practicing defensive medicine by ordering expensive tests to protect themselves from litigation is equally unpersuasive. Susan Steinman, the American Association for Justice’s director of policy, argued that hospitals and doctors seek additional tests to make more money, not because of the fear of lawsuits. Defensive medicine is not nearly the issue that doctors make it out to be and is more of a red herring to distract from real problems with the health care system, she said.

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How do we cap medical malpractice without capping medical malpractice awards for those patients who are injured by the negligence of doctors. Everyone agrees that the health care system in the United States is in need of a drastic overhaul. The key is accomplishing an overhaul without further abridging the rights of the needy.

Andy Hoffman in Friday’s Daily Kos Online wrote an excellent editorial suggesting a novel, yet thusfar, unexplored solution to reducing the cost of medical malpractice claims on society. Weed out the worst offenders, those doctors who repeatedly victimize their patients and have no business practicing medicine.

Focusing on medical malpractice caps will do nothing to reduce health care costs. California, as Hoffman notes, has had caps on medical malpractice awards for the past 34 years. The caps in california are drastic, $250,000 limits on malpractice awards, and have had literally no effect on the cost of malpractice insurance or the price of health care in that state. Why not focus on the cause of medical malpractice cases and the conduct of those bad doctors who are driving up prices for everyone else, rather then the victims? Sounds reasonable to us.