The Costs of Medical Malpractice Coverage

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Medical malpractice

Medical malpractice premiums for New York physicians in some specialties can vary by more than $100,000 depending upon geography, according to an analysis issued today by Excellus BlueCross BlueShield (BCBS).

"Medical malpractice rates for New York physicians are neither the highest nor the lowest in the country, but they continue to be an issue of concern," said Dr. Martin Hickey, Excellus BCBS senior vice president for health care affairs. "It's well established that fears of malpractice liability can lead physicians to expensive defensive medicine practices that don't help the patient and waste precious resources."

"The Facts About NYS Medical Malpractice Coverage Premiums" shows that the standard premium for an internist in Rochester ($5,642) is 375 percent lower than for an internist practicing on Long Island ($26,847). A similar differential exists for other types of physicians. For example, a general surgeon's premium rate in Rochester is $18,026, contrasted with a Long Island surgeon's rate of $85,772; and obstetrician/gynecologists in Rochester may pay $30,084 while their Long Island counterparts face a standard rate of $143,148.

"Few people understand the costs related to medical malpractice coverage, so we felt it was important to get the basic facts to the public to enhance any debates regarding malpractice," said Mary Paris, Excellus BCBS health policy director.

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Physicians pose varying risks of liability on the basis of their type of specialty, experience factors and the experience of other physicians in the regions where they practice medicine. Standard rates are reviewed and approved by the state Department of Insurance.

From the standard rates, discounts, credits, experience factors and other considerations are used in determining the actual premiums paid by individual physicians. The data presented in the fact sheets for New York State physicians is based on standard premium rates for the year 2005 of the Medical Liability Mutual Insurance Co. (MLMIC), which insures most physicians in the state.

"What the facts show is that upstate physicians generally have more favorable premium rates than downstate, and in some cases, the rates are close to states that have among the lowest premiums in the country, based on data we've seen from national surveys," Dr. Hickey said.

Standard medical malpractice premiums for typical physicians in New York state are referred to as "occurrence policies" that provide up to $1.3 million liability coverage for a single injury and up to $3.9 million for a single policy year. New rates affecting most physicians, effective July 1, rose by 7 percent, reflecting the increasing costs of malpractice claims payments statewide.

"We share our physicians' concerns about malpractice premium rate increases and the rise in the cost of malpractice claims payments reported by MLMIC," Dr. Hickey said. Excellus BlueCross BlueShield has been an advocate with such organizations as the Medical Society of the State of New York and the Business Council on the need for tort reforms that would help lower medical malpractice costs as well as other liability expenses faced by other businesses in the state.

A free copy of "The Facts About NYS Medical Malpractice Coverage Premiums" fact sheet can be downloaded by going to www.excellusbcbs.com and clicking on "Public Policy & Research."

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