Provides for the reporting of medical malpractice to the office of professional medical conduct

Summary of specific provisions

Adds new subsection 9-b to §230 of the Public Health Law to require the Office of Professional Medical Conduct (OPMC) to initiate professional misconduct proceedings against any physician who has accrued three reports within a 5-year period, including reports already required to be made to the OPMC in the New York Codes Rules and Regulations.

Adds new paragraphs (3) and (4) to subsection (b) of §315 the Insurance Law and amends other paragraphs of the same section to require insurance companies to report any medical malpractice dispositions against a medical professional to OPMC.

Adds a new paragraph (7) to subsection (b) of §4803 the Insurance Law to require a managed care company or organization to report the termination of a physician's contract to OPMC, as well as a physician's resignation upon an internal conduct investigation.

Adds new subsection (10) to § 170.10 of the Criminal Procedure Law to require courts to report the filing of a misdemeanor criminal conviction against a physician to OPMC as well as to that physician's employer(s).

Adds new § 180.90 to the Criminal Procedure Law to require courts to report the filing of a felony criminal indictment against a physician to (OPMC as well as to that physician's employer, if the criminal indictment relates to the physician's employment.

Existing law

Current law requires only minimal and periodic reporting from insurance companies, hospitals and district attorneys as to instances of professional misconduct by physicians. Most reporting does not go to OPMC, which is responsible for overseeing such conduct. Reports of dispositions from medical malpractice insurance carriers upon judgment or settlement are currently required, but only to the Department of Health; those reports are not received by OPMC. Hospitals are the

only entity required to report termination for conduct to OPMC. Even still, many incidents within those realms go unreported through loop-holes in the current reporting mechanisms. Additionally, even when credible reports are received, no mandate exists requiring OPMC to act in disciplining or even investigating the health care providers who are the subject of such reports.

Justification

Two percent of physicians in the state of New York account for over 1/3 of the medical malpractice payouts in the state. Nearly 90% of physicians in New York have not paid a single malpractice claim in the last decade. This super-minority of medical professionals has plagued the rest of the dignified profession who practice medicine responsibly but find it difficult to afford the costs of medical malpractice insurance premiums. Not only are they a detriment to their professional colleagues, but a danger to patients as well.

Nationally, only 16% of those doctors who paid out 5 or more medical malpractice claims in ten years faced any kind of licensure action. This proposed legislation will effectively add meat to the bare boned policy of holding doctors accountable for their actions, especially recurring ones. For example, in New York between 1988 & 1998, 15 practitioners accounted for 412 medical malpractice suits and yet only two of them lost their license. By requiring reporting from all relevant sources and mandating action by OPMC after enough reports have piled up against one individual in a short period of time, this legislation ensures that a timely investigation is done and any wan-anted action is taken to combat bad professional conduct by physicians.

This bill will drive down costs of medical malpractice insurance in the state by identifying and removing bad doctors quickly, thus reducing the occurrences of actual medical malpractice. The entire medical profession in New York does not deserve to suffer from the actions of a minority of its practitioners, and neither do patients. This bill seeks to single out those few "bad apples" and make sure that patients as well as other doctors are protected from their harmful acts.

Prior legislative history

2005: A.7829/S.4906 - Assembly Calendar/Senate Insurance Committee 2006: A.7829/S.4906 - Assembly Health Committee/Senate Insurance Committee 2007: A.5995B/S.6534A - Assembly Health Committee/Senate Rules Committee 2008: A.5995B/S.56534A - Assembly Codes Committee/Senate Health Committee

Fiscal implications

None. There exists no fiscal implication to the state as OPMC is currently staffed and funded sufficiently to handle the increase in conduct reports likely to be generated by this legislation.

Effective date

90 days following enactment.