American College of Emergency Physicians

Maryland

Recent Reforms Enacted (since 2003)	Passed a 2% tax on HMO premiums to fund state subsidy of some liability premiums and increased Medicaid payments to some specialists including emergency physicians. Capped premium rate increases for physicians at 5% in 2005, solidified noneconomic damage cap at $650,000 in most cases, stricter qualifications for expert witnesses, required a more detailed certificate of merit from an expert and required mediation before liability lawsuits proceed to trial. (2005)
Emergency Care Provision	None
Reform Elements In Law	$650K Soft Cap Expert Witness Periodic Payments Periodic Payments Mandatory mediation Premium Subsidy I’m Sorry Law
Constitutional Status of Reforms	In April 2009 a Circuit Judge ruled that the cap on damages as written only applies to liability cases that have previously gone through the pre-trial arbitration process, which either side could waive. In October 2010, the Court of Appeals of Maryland upheld the state's cap on noneconomic damages. (2013) Coleman v. Columbia Soccer Association in which the court declined to overturn the doctrine of contributory negligence standard, which prevents plaintiffs from collecting damages when their negligence contributed to their injury.
Change in Insurance Rates	In August 2005, Medical Mutual Liability announced that liability rates would remain unchanged for the next year. Med Mutual, the state's largest insurer, collected more than $27 million in 2005 from the new 2% tax on HMOs created to help pay for liability coverage. In September 2004, Medical Mutual Liability Insurance raised physician premiums 33%, and their rates had increased by 66.8% since 2003. In November 2003, a Maryland ACEP survey showed emergency physicians in the state experienced an average increase in premiums of about 60 percent in 2003. The Medical Mutual Liability Insurance plans to reduce premium rates for physicians by 8% in 2007, a move that would mark the first reduction since at least 1992.
Insurance Availability	Medical Mutual Liability insures about 75 percent of physicians in Maryland, according to the state Insurance Administration
Change in Physician Availability	Information not available.
Change in Cases Filed/Awards	280 paid claims in 2003 or 13 per 1000 active nonfederal physicians. US avg. was 18.8 per 1000. 232 paid claims in 2005 or 10.7 per 1000 active nonfederal physicians. US avg. was 17.1 per 1000. (Kaiser) 192 total number of paid claims for 2006 or 7.8 per 1,000 active, non-federal physicians. 172 paid claims in 2007.