Congress to steer clear of medical malpractice regulatory changes

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Medical malpractice insurance will not be affected by Congress’ consideration of changes to federal antitrust regulations.

Medical malpractice insurance has been excluded from a House of Representatives’ bill that would eliminate portions of the McCarran-Ferguson Act in governing the insurance industry. The McCarran-Ferguson Act, passed in 1945, exempts the business of insurance from most federal regulation, but Congress and President Barack Obama have been looking at federal oversight of health insurance as a means of cutting costs.

“Medical professional liability insurance is not a health insurance product and should not be included in any McCarran-Ferguson reforms,” said representatives of the American Insurance Association and the Property Casualty Insurers Association of America in a joint statement.  “We’re appreciative of this important recognition by lawmakers not to include medical professional liability insurers as part of these proposed reforms.”

The two groups added that every state has “a comprehensive insurance regime that governs the insurance industry, including subjecting the industry to antitrust enforcement. Medical liability insurers, like other property-casualty companies, are subject to this overarching enforcement structure.”

The House bill introduced by Rep. Tom Perriello (D-Va.) – the Health Insurance Industry Fair Competition Act – seeks to prohibit the sharing by health insurers of statistical trend analyses of historical loss-cost data, which is used by underwriters to determine the most efficient and low-cost insurance premiums.

The exclusion of medical malpractice insurance, which had been sought by several insurance industry trade groups, drew a favorable response from the Self-Insurance Institute of America, a national trade association that represents companies involved in the self-insurance and alternative risk transfer industry.

“This decision by Congress will preserve the existing ability of self-insured risk retention groups to provide medical liability insurance to their members,” said Kevin Doherty, chair of SIIA’s Alternative Risk Transfer Committee, in a statement.

The House bill seemed likely to target both health insurers and medical malpractice insurers.

Including medical malpractice insurers could have been particularly damaging to the formation of risk retention groups organized to cover medical liability risks, according to the SIIA. When risk retention groups were enabled, under the federal Liability Risk Retention Act of 1986, groups comprised of hospitals, physicians and other medical specialties formed their own insurance companies against the risk of malpractice suits.

“These risk retention groups helped to provide insurance solutions for health care providers and reduced the impact of the malpractice crisis that had begun to cripple health care in many states,” Doherty said.

Forming medical liability risk retention groups would be extremely difficult if they were included in the new law. ”Loss-cost data is the tool they need to be competitive and provide meaningful solutions to healthcare providers to help manage medical practice liability claims,” Doherty said.

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