AUSTIN, Texas August 03 (BestWire) According to a 357-page article in the latest edition of Texas Tech Law Review, Texas' two-year-old House Bill 4 and Proposition 12 reform measures could turn the tide toward sanity and stability in the state's medical liability system."We believe the law review article will undergird the work of the legislators and probably dissuade appeals, as the legislative intent is made clear," said Jon Opelt, executive director of Texas Alliance for Patient Access, which, along with its 300 affiliate organizations, pushed for the landmark liability reforms in 2003.

"On the surface, House Bill 4 had more than 200 changes in the law. So it's a dramatic rewrite," Opelt said. "As such, it's difficult for practitioners to understand all of the changes, and so they set out to produce a reference guide to help (the legal community) better understand the changes."

On June 11, 2003, Gov. Rick Perry signed into law House Bill 4, which introduced a $250,000 limit on noneconomic, or "pain and suffering" damages, as well as a $750,000 overall limit per case. The public backed up the bill by approving the state constitutional amendment Proposition 12, which allowed liability insurance premiums to immediately decrease by circumventing a possible 10-year wait for the state Supreme Court to determine whether caps were permitted under the Texas Constitution.

"Two years ago, Texas lawmakers passed arguably the most expansive rewrite of the state's civil justice laws since the adoption of the Texas constitution 140 years ago," Walter Huffman, dean of the Texas Tech University School of Law said in a statement. The law review article "is intended as ... a road map to what lawmakers intended to enact," he said.

The review, written by six Texas attorneys, weaves together legislative testimony and debate, commentary during floor votes, and research submitted for the record to capture what legislators had in mind when they made the decisions they did.

State Rep. Joe Nixon, a civil litigation attorney who co-authored the article, said the reforms put in place by HB 4 went beyond medical-malpractice liability, to include everything from class action and product liability to emergency-room care and immunity for school teachers. Nixon often travels the United States, giving speeches and visiting legislators on the subject of tort reform.

What happened in Texas, Nixon said, proves civil justice reforms work to the benefit of insureds as well as insurers.

"I do think it's that big of a deal. If you saw how hard it was fought by trial attorneys, you would understand," Nixon said. "Over the years, things slowly eroded in Texas. We had 40% to 60% of all asbestos claims in the United States filed here. Since the reforms, we have seen a 50% drop in civil lawsuits."

From the perspective of how bad things were prior to the reforms, the article cites the hospitals that were turning away ambulances due to a shortage of doctors and nurses; a quadrupling of the average medial liability awards, from $472,932 in 1989 to $2 million in 1999; a departure of 13 carriers from the market between 1999 and 2003, and a legal system in which 85% of medical-liability claims against Texas physicians were closed with no payment made to the patient.

Early returns show a growing list of benefits that are being realized as a result of the reforms, according to the report. These include:

— Since May 2003, more than 3,000 new doctors have established practice in Texas

— From four carriers in 2002, the market has seen the arrival of 22 new carriers

— The number of physicians enrolled in the Joint Underwriting Association, the state pool of last resort, has seen a steady decline, while the number of practicing neurosurgeons and emergency care, orthopedic physicians has grown dramatically

—The Texas Medical Liability Trust, the largest physician liability insurer in Texas, experienced a total rate reduction of 16.4%, representing a $34 million rate savings for doctors
(By Eleanor Barrett, senior associate editor, BestWeek:
eleanor.barrett@ambest.com) BN-NJ-08-03-2005 1600 ET #