Political Activism

From the Statehouse

Beverly Lynch’s Report

June 15, 2010

It has been a very busy time for the ob/gyn community in the Statehouse. Last week, Dr. Sharon Mass spent 45 minutes in front of the inaugural meeting of the Women’s Legislative Caucus discussing barriers to access to women’s health care. She received great press (NJN News) and accolades from the legislators.

Then, later in the same week, Dr. DeStefano addressed the Assembly Health and Human Services Committee on the importance of reform to the medical liability system. While that bill wasn’t released (it was “for discussion only”), it provided good visibility for ACOG. [If anyone needs copies of the testimony presented at either of these hearings, please email me at BLYNCH@BLYNCHASSOCIATES.COM] Dr. Westover attended both hearings.

ACOG-NJ also met last week with the NJ Department of Banking and Insurance as they struggle with drafting the regulations that would implement the maternity installment payment statute. Karen Ryer from Lifeline shared her expertise on coding and methodology. Drs. Mass and Westover also participated in that meeting with me.

And now, on Thursday, June 17, another important initiative for ob/gyns is scheduled for a hearing: A-2807, would renew the medical liability subsidy fund for five years. This bill will be heard in the Assembly Health and Human Services Committee at 10 am, and Dr. Mass will be testifying. Attached are her remarks. The statement for the bill is posted below.

“Good morning, Chairman Conaway and members of the Committee.

On behalf of the New Jersey Section of the American Congress of Obstetricians and Gynecologists, representing more than 1,775 New Jersey Obstetrician-Gynecologists, I’d like to thank you for the opportunity to speak today.

My name is Dr. Sharon Mass, and I am the Section Vice-Chair. I have been a practicing ob/gyn in Morristown, New Jersey for the past 13 years. I practice as part of Lifeline Medical Group, a group of more than 100 ob-gyns who take care of 11% of the women in the State.

Just last week, I had the privilege of addressing the inaugural meeting of the Women’s Legislative Caucus and discussed the barriers surrounding access to quality women’s health care.

We strongly support A-2807, which would extend the medical malpractice subsidy fund, as one of the many tools that would address the access problems.

Six years ago, when this fund was first put into place, the medical community – especially ob/gyns – were in crisis. Medical liability insurance rates were skyrocketing at unprecedented rates. Physicians were dropping out of obstetrical practice, or leaving the State.

I know you heard from many last Thursday during the hearing on tort reform, including my colleague, Dr. Joe DeStephano.

The liability crisis in this state continues to be an enormous issue for Obstetrician-Gynecologists. Rates for liability insurance for Ob-Gyns in this state have consistently been well above the average. In 2009, NJ ob-gyns paid the seventh highest premium of all states in the nation; on average, NJ ob-gyns paid $110,439 or higher while the National average was $81,353. This has climbed significantly since 2002 when the national average was $59, 809.

Fear of being sued is one of the biggest barriers to care throughout the State and the Nation. The United States provides exceptional medical education, training some of the world's finest obstetricians and gynecologists. Yet, 90% of ACOG Fellows report they have been sued at least once. On average, ob/gyns are sued 2.7 times during their careers, and nearly 60 % have made changes to their practice during the last three years because of the high risk of liability claims. 35% have either decreased the number of high-risk obstetric patients treated or have ceased providing obstetric care altogether; 15% have decreased gynecologic surgical procedures. The average age at which physicians cease practicing OB is now 48 years, an age once considered near the midpoint of an ob-gyn’s professional career.

The subsidy, while not a permanent solution, did help reduce the burden. For the three years it was issued, it was a vital safety net for over 730 ob-gyns in our state, especially as physician payment has decreased and physician practice costs are rising.

We know you agree that permanently addressing the medical liability dilemma in New Jersey is critical for the future of health care delivery.

As you would expect, and as you heard last week, most of the residents graduating from their New Jersey program don’t remain in New Jersey to practice – further exacerbating the problem.

These numbers and percentages suggest there could be considerable challenges to New Jersey's ability to deliver quality health care. In order to attract young physicians to our state, the medical liability dilemma must be resolved.

Thank you for your consideration and anticipated support of -2807. We are eager to work with you on these critical problems. “

We realize securing passage of this bill is an uphill battle, and that this issue has been deemed the number one priority for the NJ Bar Association (they are committed to killing it). Having said that, we are hopeful that the committee will release this bill, in deference to their Chairman, the sponsor, Assemblyman Herb Conaway, and the Assembly Speaker will schedule it for a vote for the floor. Stay tuned. For now, thanks again to Dr. Mass for spending her morning in Trenton.

STATEMENT ON A-2807

This bill extends the Medical Malpractice Liability Insurance Premium Assistance Fund for five years and reestablishes the collection of annual surcharges for the fund for the five-year period.

The primary purpose of the fund is to provide medical malpractice liability insurance premium subsidies to health care providers who, as a class of providers, are most severely impacted by high medical malpractice premium rates. In addition, monies from the fund are allocated for various health care purposes, including funds: to the Health Care Subsidy Fund for charity care subsidies to hospitals, to the NJ FamilyCare Program, and to provide student loan expense reimbursement for certain obstetrician/gynecologists.

The surcharges apply to all employers subject to the “unemployment compensation law,” ($3 per employee each year), and to practicing physicians, podiatrists, chiropractors, dentists, optometrists, and attorneys licensed in this State ($75 each year).

The bill repeals sections 29 and 30 of P.L.2004, c.17. The provisions of section 29, concerning student loan expense reimbursement for certain obstetricians/gynecologists, had expired three years after the effective date of P.L.2004, c.17, and this bill reenacts those provisions as section 3 of the bill. The provisions of section 30 concerning NJ FamilyCare coverage for certain pregnant women whose income is up to 100% of the federal poverty level, are no longer necessary since eligibility for Medicaid was expanded in 2005 to cover parents and children whose income is up to 133% of the federal poverty level. The monies from the Medical Malpractice Liability Insurance Premium Assistance Fund that had been allocated in 2004 to the coverage of pregnant women will now be allocated to the NJ FamilyCare Program.

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Beverly Lynch

B. Lynch Associates

(609) 392-7553

Around New Jersey

In a 6 - 1 Decision, N.J. Supreme Court Guts Affidavit of Merit Statute

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