Missouri Senate

Introduced

This act provides a definition for the term "claim" as it is used in the medical malpractice insurance claims reporting provisions. The act also provides a definition for the term "self-insurer" for those provisions as the act subjects persons and other entities that assume liability for the payment of medical malpractice claims to the data and claims reporting provisions of Sections 383.100 to 383.125 (Section 383.100).

Under the act, the director must submit certain information to appropriate health care licensing boards. The director must also submit a report containing certain medical malpractice claims information to the Department of Social Services so that it can determine whether the injured party was concurrently enrolled in Mo HealthNet when the alleged malpractice occurred.

The act institutes new confidentiality rules related to the disclosure of data related to the medical malpractice claim information submitted to the director. All medical malpractice claims data submitted to the director shall be considered confidential and immune from Sunshine Law requests.

Medical malpractice claims data that is the subject of a filed lawsuit may only be released after the claims are closed and in a prescribed format outlined by the act. All data elements that reasonably could reveal any parties involved, either directly or indirectly, to a malpractice actions or claims, shall be removed prior to making any such data public. Any references to a county or smaller geographic unit shall be suppressed, though county-level data may be released in aggregate form. No records that include any indemnity payments or expense amounts that identify a particular medical specialty may be released on an individual record basis unless there are a minimum of four additional claims during an annual period against practitioners of the same medical specialty for each identifiable unit of geography. All dates shall be anonymized prior to public release. Specific dates shall not be released in any form more precise than the year corresponding to the date. Data that reasonably could identify an insurer shall be anonymized prior to the public release of the individual claim records. The name and any identifying codes of an insurer shall not be made public (Section 383.105).

The act implements new rules regarding the reporting of medical malpractice premium, loss and exposure data. Under the act, insurers and self-insurers must annually report the following:

(1) Aggregate premium;

(2) Written and earned premium;

(3) Aggregate exposure;

(4) Written and earned exposures; and

(5) Aggregated indemnity paid and aggregate indemnity incurred by not paid.

The act specifically provides that the medical malpractice claims data and premium data shall be shared with the Health Care Stabilization Fund Feasibility Board in a confidential manner.

The medical malpractice premium, loss and exposure data reported to the director is deemed confidential information under the act and is not discoverable or admissible as evidence in any legal action in any civil, criminal, or administrative proceeding, nor shall any of the data be released by the director to the public.

The act also deems the data collected by the department to be a trade secret. As a trade secret, the submitted data is immune from Sunshine Law requests. The act also deems the data collected by the department to be proprietary and confidential (Section 383.106).

This act provides the directors of the Medical Malpractice Joint Underwriting Association may provide medical malpractice insurance coverage as determined by the directors. The policies may provide coverage on a claims-made, an occurrence, or a prior-acts basis. Under the current law, the association may only issue occurrence-based policies (Section 383.160).

The act also modifies the law with respect to the surcharge paid by association members during their first year of medical malpractice coverage. Under the act, an association member must pay a surcharge in an amount equal to 25% of the member’s premium payment (Section 383.165).

This act extends the sunset provision on the Health Care Stabilization Fund Feasibility Board from December 31, 2010, to December 31, 2012 (Section 383.250).

Under current law, a physician or surgeon that practices in a hospital located in a county with a population greater than 75,000 must furnish evidence of a medical malpractice insurance policy of at least $500,000. This act provides that no hospital shall require a medical malpractice insurance policy in an amount greater than $500,000 in order to be admitted or retained in the medical staff. Under current law, other hospitals within the state can require their physicians to carry minimum levels of medical malpractice insurance as a condition of membership on a hospital medical staff. This act provides that the maximum level that a hospital may require is $500,000 (Section 383.500).

STEPHEN WITTE