NEWS & TRENDS

 

Fam Pract Manag. 2007 Jun;14(6):15.

Payments on medical malpractice claims approach $4 billion

Payments made for medical malpractice claims against physicians reached nearly $4 billion in 2006, with the average claims payment totaling more than $300,000, according to a Kaiser Family Foundation analysis of data from the National Practitioner Data Bank.

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Average claims paymentsTotal dollars in paid claims

United States

$308,593

$3,861,429,200

Top 10 states

Illinois

$629,107

$225,220,250

Delaware

$560,970

$18,512,000

Wisconsin

$517,593

$34,678,750

Connecticut

$509,276

$76,900,750

Minnesota

$477,873

$30,106,000

Massachusetts

$473,684

$123,631,550

Wyoming

$423,056

$7,615,000

New York

$413,747

$704,198,100

New Jersey

$393,808

$206,355,300

Alabama

$387,012

$15,867,500

Bottom 10 states

South Dakota

$224,625

$4,492,500

Nebraska

$219,739

$14,502,750

Louisiana

$213,952

$72,529,750

New Mexico

$197,342

$17,760,750

West Virginia

$182,640

$14,063,250

South Carolina

$170,763

$31,249,550

Texas

$169,980

$106,747,250

Kansas

$154,905

$20,292,550

Vermont

$145,111

$2,612,000

Michigan

$132,380

$51,495,750


Source: Kaiser Family Foundation analysis of data from the National Practitioner Data Bank (NPDB). Public Use Data File (NPDB0606.POR). Available at: http://www.npdb-hipdb.com/publicdata.html. Accessed May 18, 2007.

Average claims paymentsTotal dollars in paid claims

United States

$308,593

$3,861,429,200

Top 10 states

Illinois

$629,107

$225,220,250

Delaware

$560,970

$18,512,000

Wisconsin

$517,593

$34,678,750

Connecticut

$509,276

$76,900,750

Minnesota

$477,873

$30,106,000

Massachusetts

$473,684

$123,631,550

Wyoming

$423,056

$7,615,000

New York

$413,747

$704,198,100

New Jersey

$393,808

$206,355,300

Alabama

$387,012

$15,867,500

Bottom 10 states

South Dakota

$224,625

$4,492,500

Nebraska

$219,739

$14,502,750

Louisiana

$213,952

$72,529,750

New Mexico

$197,342

$17,760,750

West Virginia

$182,640

$14,063,250

South Carolina

$170,763

$31,249,550

Texas

$169,980

$106,747,250

Kansas

$154,905

$20,292,550

Vermont

$145,111

$2,612,000

Michigan

$132,380

$51,495,750


Source: Kaiser Family Foundation analysis of data from the National Practitioner Data Bank (NPDB). Public Use Data File (NPDB0606.POR). Available at: http://www.npdb-hipdb.com/publicdata.html. Accessed May 18, 2007.

Senate committee investigates insurers' hard-sell tactics targeting seniors

On the heels of numerous media reports alleging that insurance sales agents have used unethical or illegal practices to enroll Medicare beneficiaries into Medicare Advantage plans, the Senate Special Committee on Aging held a hearing on the matter in May.

Oklahoma state insurance commissioner Kim Holland testified, “Over the past year we have received hundreds of complaints from our citizens who have been misled or deceived during a sale. … Unlicensed agents are setting up shop in pharmacies, Wal-Marts and nursing home lobbies to prey upon seniors' confusion and concern over their medical care coverage. Certain insurers are exploiting their exemption from regulatory oversight with aggressive and frequently misleading advertising; agent financial incentives that encourage high-pressure sales tactics; and a lack of responsiveness, if not outright neglect of a vulnerable population caught in the middle of an unbridled free market.”

Citing a survey conducted by the National Association of Insurance Commissioners, Wisconsin insurance commissioner Sean Dilweg noted that “37 out of 43 states have reported receiving complaints about inappropriate or confusing marketing practices leading Medicare beneficiaries to enroll in a Medicare Advantage plan without adequately understanding their choice to remain in traditional Medicare or without adequate understanding of the consequences of their decision. Beneficiaries believed they were signing up for a Medicare Part D stand-alone drug plan or a Medigap plan to supplement their traditional Medicare, but instead they were enrolled into a Medicare Advantage plan.”

Beneficiaries who enroll in the new plans may be required to pay higher co-payments and may no longer be able to see their primary care physician if he or she does not participate with the plan.

Representatives from the Association of Health Insurance Plans and several national insurers said their companies are committed to improving the training of sales agents and using safeguards such as post-enrollment phone calls to confirm beneficiaries' intent to enroll.

Committee Chair Herb Kohl (D-Wis.) said he would draft legislation giving state regulators greater authority to take enforcement action against the companies that sell Medicare Advantage plans.

 

Copyright © 2007 by the American Academy of Family Physicians.
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