Bill Text: FL S0248 | 2024 | Regular Session | Comm Sub


Bill Title: Medical Negligence

Spectrum: Bipartisan Bill

Status: (Failed) 2024-03-08 - Died in Fiscal Policy [S0248 Detail]

Download: Florida-2024-S0248-Comm_Sub.html
       Florida Senate - 2024                              CS for SB 248
       
       
        
       By the Committee on Judiciary; and Senators Yarborough, Burgess,
       Book, Hutson, Perry, and Stewart
       
       
       
       
       590-02354-24                                           2024248c1
    1                        A bill to be entitled                      
    2         An act relating to medical negligence; amending ss.
    3         400.023, 400.0235, and 429.295, F.S.; conforming
    4         provisions to changes made by the act; amending s.
    5         766.118, F.S.; deleting the definition of the term
    6         “catastrophic injury”; revising the limits on
    7         noneconomic damages for personal injury or wrongful
    8         death arising from medical negligence; making
    9         technical changes; amending s. 768.21, F.S.; deleting
   10         a provision that prohibits adult children and parents
   11         of adult children from recovering certain damages in
   12         medical negligence suits; requiring that medical
   13         malpractice insurer rate filings reflect certain
   14         changes in costs and expenses; requiring the Office of
   15         Insurance Regulation to consider such changes in its
   16         review of rate filings; authorizing the Office of
   17         Insurance Regulation to develop certain methodology
   18         and data in reviewing rate filings by medical
   19         malpractice insurers; requiring the Office of Program
   20         Policy Analysis and Government Accountability to study
   21         the efficacy of caps on noneconomic damages and to
   22         report its findings and recommendations to the
   23         Governor and the Legislature by a specified date;
   24         reenacting s. 766.209(3)(a), F.S., relating to effects
   25         of failure to offer or accept voluntary binding
   26         arbitration, to incorporate the amendment made to s.
   27         766.118, F.S., in a reference thereto; providing
   28         applicability; providing an effective date.
   29  
   30         WHEREAS, the Legislature finds that expanding the right to
   31  recover noneconomic damages for wrongful death caused by medical
   32  negligence furthers an important state interest of promoting
   33  accountability and adherence to the applicable standards of
   34  care, and
   35         WHEREAS, the Legislature further recognizes that the
   36  expansion of the right to recover damages must be balanced
   37  against the important state interests of minimizing increases in
   38  the cost of malpractice insurance and promoting the availability
   39  of quality health care services, and
   40         WHEREAS, the Legislature finds that limitations on
   41  noneconomic damages in medical negligence cases further the
   42  critical state interest in promoting the affordability and
   43  availability of health care services, and
   44         WHEREAS, the Legislature finds that the cases of Estate of
   45  McCall v. United States, 134 So. 3d 894 (Fla. 2014) and North
   46  Broward Hospital District v. Kalitan, 219 So. 3d 49 (Fla. 2017),
   47  which invalidated limits on noneconomic damages, were decided
   48  contrary to legislative intent and prior case law interpreting
   49  the equal protection clauses of the United States Constitution
   50  and the State Constitution, and
   51         WHEREAS, the cases of Estate of McCall v. United States and
   52  North Broward Hospital District v. Kalitan are inconsistent with
   53  the decisions of other courts addressing limits on damages, and
   54         WHEREAS, the Legislature finds that the state has the
   55  highest medical malpractice insurance premiums in the nation and
   56  is in a sustained and continuing crisis of affordability with
   57  respect to the price of medical malpractice insurance, and
   58         WHEREAS, the Legislature finds that having the highest
   59  medical malpractice insurance premiums in the nation is causing
   60  physicians to practice medicine without malpractice insurance,
   61  begin medical careers in other states, pursue opportunities to
   62  practice in other states, abstain from performing high-risk
   63  procedures in this state, or retire early from the practice of
   64  medicine, and
   65         WHEREAS, the Legislature finds that the crisis of having
   66  the highest medical malpractice insurance premiums in the nation
   67  threatens the quality and availability of health care services
   68  for everyone in this state, and
   69         WHEREAS, the Legislature finds that the rapidly growing
   70  population and the changing demographics of this state make it
   71  imperative for the state to have a legal environment that helps
   72  to attract and retain physicians, and
   73         WHEREAS, the Legislature finds that there is an
   74  overpowering public necessity to ensure that physicians practice
   75  medicine in this state, and
   76         WHEREAS, the Legislature finds that there is also an
   77  overpowering public necessity to enact policies that prevent
   78  medical malpractice insurance premiums from being unaffordable
   79  and continuing at crisis levels, and
   80         WHEREAS, the Legislature finds that limitations on
   81  noneconomic damages in medical negligence cases further the
   82  public necessities of making quality health care available to
   83  the residents of this state, ensuring that physicians practice
   84  medicine in this state, and ensuring that those physicians have
   85  the opportunity to purchase affordable medical malpractice
   86  insurance, NOW, THEREFORE,
   87  
   88  Be It Enacted by the Legislature of the State of Florida:
   89  
   90         Section 1. Subsection (9) of section 400.023, Florida
   91  Statutes, is amended to read:
   92         400.023 Civil enforcement.—
   93         (9) An action under this part for a violation of rights or
   94  negligence recognized herein is not a claim for medical
   95  malpractice, and s. 768.21(8) does not apply to a claim alleging
   96  death of the resident.
   97         Section 2. Section 400.0235, Florida Statutes, is amended
   98  to read:
   99         400.0235 Certain provisions not applicable to actions under
  100  this part.—An action under this part for a violation of rights
  101  or negligence recognized under this part is not a claim for
  102  medical malpractice, and the provisions of s. 768.21(8) do not
  103  apply to a claim alleging death of the resident.
  104         Section 3. Section 429.295, Florida Statutes, is amended to
  105  read:
  106         429.295 Certain provisions not applicable to actions under
  107  this part.—An action under this part for a violation of rights
  108  or negligence recognized herein is not a claim for medical
  109  malpractice, and the provisions of s. 768.21(8) do not apply to
  110  a claim alleging death of the resident.
  111         Section 4. Section 766.118, Florida Statutes, is amended to
  112  read:
  113         766.118 Determination of noneconomic damages.—
  114         (1) DEFINITIONS.—As used in this section, the term:
  115         (a) “Catastrophic injury” means a permanent impairment
  116  constituted by:
  117         1. Spinal cord injury involving severe paralysis of an arm,
  118  a leg, or the trunk;
  119         2. Amputation of an arm, a hand, a foot, or a leg involving
  120  the effective loss of use of that appendage;
  121         3. Severe brain or closed-head injury as evidenced by:
  122         a. Severe sensory or motor disturbances;
  123         b. Severe communication disturbances;
  124         c. Severe complex integrated disturbances of cerebral
  125  function;
  126         d. Severe episodic neurological disorders; or
  127         e. Other severe brain and closed-head injury conditions at
  128  least as severe in nature as any condition provided in sub
  129  subparagraphs a.-d.;
  130         4. Second-degree or third-degree burns of 25 percent or
  131  more of the total body surface or third-degree burns of 5
  132  percent or more to the face and hands;
  133         5. Blindness, defined as a complete and total loss of
  134  vision; or
  135         6. Loss of reproductive organs which results in an
  136  inability to procreate.
  137         (b) “Noneconomic damages” means noneconomic damages as
  138  defined in s. 766.202(8).
  139         (b)(c) “Practitioner” means any person licensed under
  140  chapter 458, chapter 459, chapter 460, chapter 461, chapter 462,
  141  chapter 463, chapter 466, chapter 467, chapter 486, or s.
  142  464.012 or registered under s. 464.0123. “Practitioner” also
  143  means any association, corporation, firm, partnership, or other
  144  business entity under which such practitioner practices or any
  145  employee of such practitioner or entity acting in the scope of
  146  his or her employment. For the purpose of determining the
  147  limitations on noneconomic damages set forth in this section,
  148  the term “practitioner” includes any person or entity for whom a
  149  practitioner is vicariously liable and any person or entity
  150  whose liability is based solely on such person or entity being
  151  vicariously liable for the actions of a practitioner.
  152         (2) LIMITATION ON NONECONOMIC DAMAGES FOR NEGLIGENCE OF A
  153  PRACTITIONER PRACTITIONERS.—
  154         (a) With respect to a cause of action for personal injury
  155  or wrongful death arising from medical negligence of a
  156  practitioner practitioners, regardless of the number of such
  157  practitioner defendants, noneconomic damages may shall not
  158  exceed $500,000 per claimant. No practitioner shall be liable
  159  for more than $500,000 in noneconomic damages, regardless of the
  160  number of practitioners who are liable for a claimant’s damages
  161  claimants.
  162         (b) Notwithstanding paragraph (a), if the negligence
  163  resulted in a permanent vegetative state or death, the total
  164  noneconomic damages recoverable from all practitioners,
  165  regardless of the number of claimants, under this paragraph
  166  shall not exceed $1 million. In cases that do not involve death
  167  or permanent vegetative state, the patient injured by medical
  168  negligence may recover noneconomic damages not to exceed $1
  169  million if:
  170         1. The trial court determines that a manifest injustice
  171  would occur unless increased noneconomic damages are awarded,
  172  based on a finding that because of the special circumstances of
  173  the case, the noneconomic harm sustained by the injured patient
  174  was particularly severe; and
  175         2. The trier of fact determines that the defendant’s
  176  negligence caused a catastrophic injury to the patient.
  177         (c) The total noneconomic damages recoverable by all
  178  claimants from all practitioner defendants under this subsection
  179  shall not exceed $1 million in the aggregate.
  180         (3) LIMITATION ON NONECONOMIC DAMAGES FOR NEGLIGENCE OF A
  181  NONPRACTITIONER DEFENDANTS.—
  182         (a) With respect to a cause of action for personal injury
  183  or wrongful death arising from medical negligence of a
  184  nonpractitioner nonpractitioners, regardless of the number of
  185  such nonpractitioner defendants, noneconomic damages may shall
  186  not exceed $750,000 per claimant, regardless of the number of
  187  nonpractitioners who are liable for a claimant’s damages.
  188         (b) Notwithstanding paragraph (a), if the negligence
  189  resulted in a permanent vegetative state or death, the total
  190  noneconomic damages recoverable by such claimant from all
  191  nonpractitioner defendants under this paragraph shall not exceed
  192  $1.5 million. The patient injured by medical negligence of a
  193  nonpractitioner defendant may recover noneconomic damages not to
  194  exceed $1.5 million if:
  195         1. The trial court determines that a manifest injustice
  196  would occur unless increased noneconomic damages are awarded,
  197  based on a finding that because of the special circumstances of
  198  the case, the noneconomic harm sustained by the injured patient
  199  was particularly severe; and
  200         2. The trier of fact determines that the defendant’s
  201  negligence caused a catastrophic injury to the patient.
  202         (c)A nonpractitioner is defendants are subject to the cap
  203  on noneconomic damages provided in this subsection regardless of
  204  the theory of liability, including vicarious liability.
  205         (d) The total noneconomic damages recoverable by all
  206  claimants from all nonpractitioner defendants under this
  207  subsection shall not exceed $1.5 million in the aggregate.
  208         (4) LIMITATION ON NONECONOMIC DAMAGES FOR NEGLIGENCE OF A
  209  PRACTITIONER PRACTITIONERS PROVIDING EMERGENCY SERVICES AND
  210  CARE.—Notwithstanding subsections (2) and (3), with respect to a
  211  cause of action for personal injury or wrongful death arising
  212  from medical negligence of a practitioner who provided
  213  practitioners providing emergency services and care, as defined
  214  in s. 395.002(9), or provided providing services as provided in
  215  s. 401.265, or provided providing services pursuant to
  216  obligations imposed by 42 U.S.C. s. 1395dd to a person persons
  217  with whom the practitioner did does not have a then-existing
  218  health care patient-practitioner relationship for that medical
  219  condition:
  220         (a) Regardless of the number of such practitioner
  221  defendants, noneconomic damages may shall not exceed $150,000
  222  per claimant, regardless of the number of practitioners who are
  223  liable for a claimant’s damages.
  224         (b) Notwithstanding paragraph (a), the total noneconomic
  225  damages recoverable by all claimants from all such practitioners
  226  shall not exceed $300,000. The limitation provided by this
  227  subsection applies only to noneconomic damages awarded as a
  228  result of any act or omission of providing medical care or
  229  treatment, including diagnosis that occurs prior to the time the
  230  patient is stabilized and is capable of receiving medical
  231  treatment as a nonemergency patient, unless surgery is required
  232  as a result of the emergency within a reasonable time after the
  233  patient is stabilized, in which case the limitation provided by
  234  this subsection applies to any act or omission of providing
  235  medical care or treatment which occurs prior to the
  236  stabilization of the patient following the surgery.
  237         (5) LIMITATION ON NONECONOMIC DAMAGES FOR NEGLIGENCE OF A
  238  NONPRACTITIONER DEFENDANTS PROVIDING EMERGENCY SERVICES AND
  239  CARE.—Notwithstanding subsections (2) and (3), with respect to a
  240  cause of action for personal injury or wrongful death arising
  241  from medical negligence of a nonpractitioner defendants other
  242  than a practitioner who provided practitioners providing
  243  emergency services and care pursuant to obligations imposed by
  244  s. 395.1041 or s. 401.45, or obligations imposed by 42 U.S.C. s.
  245  1395dd to a person persons with whom the practitioner did does
  246  not have a then-existing health care patient-practitioner
  247  relationship for that medical condition:
  248         (a) Regardless of the number of such nonpractitioner
  249  defendants, Noneconomic damages may shall not exceed $750,000
  250  per claimant, regardless of the number of nonpractitioners who
  251  are liable for a claimant’s damages.
  252         (b) Notwithstanding paragraph (a), the total noneconomic
  253  damages recoverable by all claimants from all such
  254  nonpractitioner defendants shall not exceed $1.5 million.
  255         (c)A nonpractitioner defendants may receive a full setoff
  256  for payments made by a practitioner defendants.
  257  
  258  The limitation provided by this subsection applies only to
  259  noneconomic damages awarded as a result of any act or omission
  260  of providing medical care or treatment, including a diagnosis
  261  that occurs before prior to the time the patient is stabilized
  262  and is capable of receiving medical treatment as a nonemergency
  263  patient, unless surgery is required as a result of the emergency
  264  within a reasonable time after the patient is stabilized, in
  265  which case the limitation provided by this subsection applies to
  266  any act or omission of providing medical care or treatment which
  267  occurs before prior to the stabilization of the patient
  268  following the surgery.
  269         (6) LIMITATION ON NONECONOMIC DAMAGES FOR NEGLIGENCE OF A
  270  PRACTITIONER PROVIDING SERVICES AND CARE TO A MEDICAID
  271  RECIPIENT.—Notwithstanding subsections (2), (3), and (5), with
  272  respect to a cause of action for personal injury or wrongful
  273  death arising from medical negligence of a practitioner
  274  committed in the course of providing medical services and
  275  medical care to a Medicaid recipient, regardless of the number
  276  of such practitioner defendants providing the services and care,
  277  noneconomic damages may not exceed $300,000 per claimant,
  278  regardless of the number of practitioners who are liable for a
  279  claimant’s damages, unless the claimant pleads and proves, by
  280  clear and convincing evidence, that the practitioner acted in a
  281  wrongful manner. A practitioner providing medical services and
  282  medical care to a Medicaid recipient is not liable for more than
  283  $200,000 in noneconomic damages, regardless of the number of
  284  claimants, unless the claimant pleads and proves, by clear and
  285  convincing evidence, that the practitioner acted in a wrongful
  286  manner. The fact that a claimant proves that a practitioner
  287  acted in a wrongful manner does not preclude the application of
  288  the limitation on noneconomic damages prescribed elsewhere in
  289  this section. For purposes of this subsection:
  290         (a) The terms “medical services,” “medical care,” and
  291  “Medicaid recipient” have the same meaning as provided in s.
  292  409.901.
  293         (b) The term “practitioner,” in addition to the meaning
  294  prescribed in subsection (1), includes any hospital or
  295  ambulatory surgical center as defined and licensed under chapter
  296  395.
  297         (c) The term “wrongful manner” means in bad faith or with
  298  malicious purpose or in a manner exhibiting wanton and willful
  299  disregard of human rights, safety, or property, and shall be
  300  construed in conformity with the standard set forth in s.
  301  768.28(9)(a).
  302         (7) SETOFF.—In any case in which the jury verdict for
  303  noneconomic damages exceeds the limits established by this
  304  section, the trial court shall reduce the award for noneconomic
  305  damages within the same category of defendants in accordance
  306  with this section after making any reduction for comparative
  307  fault as required by s. 768.81 but before application of a
  308  setoff in accordance with ss. 46.015 and 768.041. In the event
  309  of a prior settlement or settlements involving one or more
  310  defendants subject to the limitations of the same subsection
  311  applicable to a defendant remaining at trial, the court shall
  312  make such reductions within the same category of defendants as
  313  are necessary to ensure that the total amount of noneconomic
  314  damages recovered by the claimant do does not exceed the
  315  aggregate limit established by the applicable subsection. This
  316  subsection is not intended to change current law relating to the
  317  setoff of economic damages.
  318         (8) ACTIONS GOVERNED BY SOVEREIGN IMMUNITY LAW.—This
  319  section does shall not apply to actions governed by s. 768.28.
  320         Section 5. Subsection (8) of section 768.21, Florida
  321  Statutes, is amended, and subsections (3) and (4) of that
  322  section are republished, to read:
  323         768.21 Damages.—All potential beneficiaries of a recovery
  324  for wrongful death, including the decedent’s estate, shall be
  325  identified in the complaint, and their relationships to the
  326  decedent shall be alleged. Damages may be awarded as follows:
  327         (3) Minor children of the decedent, and all children of the
  328  decedent if there is no surviving spouse, may also recover for
  329  lost parental companionship, instruction, and guidance and for
  330  mental pain and suffering from the date of injury. For the
  331  purposes of this subsection, if both spouses die within 30 days
  332  of one another as a result of the same wrongful act or series of
  333  acts arising out of the same incident, each spouse is considered
  334  to have been predeceased by the other.
  335         (4) Each parent of a deceased minor child may also recover
  336  for mental pain and suffering from the date of injury. Each
  337  parent of an adult child may also recover for mental pain and
  338  suffering if there are no other survivors.
  339         (8)The damages specified in subsection (3) shall not be
  340  recoverable by adult children and the damages specified in
  341  subsection (4) shall not be recoverable by parents of an adult
  342  child with respect to claims for medical negligence as defined
  343  by s. 766.106(1).
  344         Section 6. (1)Every medical malpractice insurer and every
  345  medical malpractice insurer rate filing made with the Office of
  346  Insurance Regulation on or after January 1, 2025, must reflect
  347  the projected changes in claim frequency, claim severity, and
  348  loss adjustment expenses, including for attorney fees, and any
  349  other change actuarially indicated, due to the combined effect
  350  of the applicable provisions of this act in order to ensure that
  351  rates for such insurance accurately reflect the risk of
  352  providing such insurance.
  353         (2) The Office of Insurance Regulation shall consider in
  354  its review of rate filings made on or after January 1, 2025, the
  355  projected changes in costs associated with the amendments to ss.
  356  766.118 and 768.21(8), Florida Statutes, by this act. The office
  357  may develop methodology and data that incorporate generally
  358  accepted actuarial techniques and standards to be used in its
  359  review of rate filings governed by this section. The methodology
  360  must account for the expected losses, by class, of insureds
  361  covered by a medical malpractice insurance, provided the
  362  methodology is consistent with generally accepted actuarial
  363  techniques and standards. Such methodology and data are not
  364  intended to create a mandatory rate increase or decrease for all
  365  medical malpractice insurers, but rather to ensure that the
  366  rates for such coverage meet the requirements of s. 627.062,
  367  Florida Statutes, and thus, are not inadequate, excessive, or
  368  unfairly discriminatory and allow such insurers a reasonable
  369  rate of return.
  370         Section 7. (1) The Office of Program Policy Analysis and
  371  Government Accountability shall study the efficacy of the
  372  statutory caps imposed by this act on noneconomic damages in
  373  actions for personal injury or wrongful death arising from
  374  medical negligence. The office may retain experts as are
  375  reasonably necessary to complete the study. The study must
  376  include, but need not be limited to, an evaluation of the
  377  current, historical, and forecast data of the following:
  378         (a) The availability, affordability, and volatility of
  379  professional liability insurance coverage for medical
  380  negligence.
  381         (b) The per capita supply of licensed physicians in this
  382  state, including those in high-risk specialties that may
  383  include, but are not limited to, internal medicine, general
  384  surgery, and obstetrics and gynecology.
  385         (c) The extent to which physicians in this state are forced
  386  to practice medicine without professional liability insurance,
  387  leave the state, refrain from practice in high-risk specialties,
  388  or retire early from the practice of medicine.
  389         (d) Evidence of the relationship between the statutory caps
  390  and changes in the matters addressed in paragraphs (a), (b), and
  391  (c).
  392         (2) By December 31, 2029, the office shall submit a report
  393  to the Governor, the President of the Senate, and the Speaker of
  394  the House of Representatives which includes findings from its
  395  study and recommendations as to whether the statutory caps on
  396  noneconomic damages should be retained, modified, or eliminated.
  397         Section 8. For the purpose of incorporating the amendment
  398  made by this act to section 766.118, Florida Statutes, in a
  399  reference thereto, paragraph (a) of subsection (3) of section
  400  766.209, Florida Statutes, is reenacted to read:
  401         766.209 Effects of failure to offer or accept voluntary
  402  binding arbitration.—
  403         (3) If the defendant refuses a claimant’s offer of
  404  voluntary binding arbitration:
  405         (a) The claim shall proceed to trial, and the claimant,
  406  upon proving medical negligence, shall be entitled to recover
  407  damages subject to the limitations in s. 766.118, prejudgment
  408  interest, and reasonable attorney’s fees up to 25 percent of the
  409  award reduced to present value.
  410         Section 9. This act applies to causes of action that accrue
  411  on or after July 1, 2024.
  412         Section 10. This act shall take effect July 1, 2024.

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