Thompson Coburn Health Care Law Alert

Physician Practice News

Several recent Missouri and Federal legal developments impacting physicians may be of interest to you.

Medical Malpractice Insurance Reform. A number of changes to the Missouri medical malpractice insurance law that went into effect on August 28, 2006 are expected to positively impact the cost of medical malpractice insurance. Some of the major changes include:

• Director of the Department of Insurance has been granted the authority to prohibit malpractice insurance rates that are deemed excessive, inadequate or unfairly discriminatory
• Insurers are limited from increasing malpractice rates by more than 15% or refusing to renew policies without at least a 60 day prior written notice to the insureds
• Insurance rates must be based on Missouri loss experience, if available, rather than on experience of other states
• All insurers are now required to report detailed financial, claims and rate-making data to the Department of Insurance

The full text of House Bill NO. 1837 that includes the changes to the medical malpractice insurance law can be found at:

http://www.house.mo.gov/bills061/bills/HB1837.HTM

New Missouri Collaborative Practice Requirements. Physicians practicing in collaboration with nurse practitioners or physician assistants should be aware of the following new Missouri requirements that became effective on August 28, 2006:

• Physicians must report to the Missouri Board of Registration for the Healing Arts any collaborative practice agreement and physician assistant agreement entered into on each renewal of the physician’s medical license and within 30 days after any change to the agreement
• The Board will track this information, may make this information available to the public and may routinely conduct random audits of physician practices to ensure that collaborations with nurse practitioners and physician assistants are carried out in compliance with the law

The full text of House Bill NO. 1515 that includes these new requirements can be found at:

http://www.house.mo.gov/bills061/biltxt/truly/HB1515T.HTM

Medicare Changes to Physician Reimbursement. The Centers for Medicare and Medicaid Services (“CMS”) proposed the largest ever increase in Medicare reimbursement for physician services related to patient evaluation and management. If adopted, this welcome change would reward physicians for the time and effort dedicated to evaluating a patient’s medical conditions, determining course of treatment and assisting the patient in managing their health. For example, the physician work component relative value units for an intermediate office visit, the most commonly billed physician’s service, would increase 37%. CMS expects to publish the final rule some time this fall. If the proposed changes are adopted, reimbursement increases would be effective on January 1, 2007.

Additional information about the proposal reimbursement increase can be found at CMS’s web site:

http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=1887.

If you have any questions about these recent developments feel free to contact a member of the Thompson Coburn Health Care Group.