Dentists need to know how MICRA protects the profession

By James Stephens, DDS, CDA president

Since becoming CDA’s president in November, I have had the privilege of introducing myself to many of you at meetings and events across the state.  Aside from our conversations about dentistry’s front-burner topics — fee schedules, regulations and third-party payers, to name a few — another issue is percolating that impacts every California dentist and the future of our profession, whether you are new to dentistry or a seasoned practitioner who remembers the days before MICRA.

The Medical Injury Compensation Reform Act of 1975 protects dentists and other health care providers from frivolous lawsuits and outrageous malpractice rates that drove many practitioners out of the state. The law is now under attack by trial lawyers who are circulating petitions to force a November ballot initiative, in essence to allow bigger payouts to pad their pockets.

Below is a Q&A that outlines why we need to preserve MICRA and support the fight that CDA and other health care organizations are involved in this year.

What is MICRA and how does it impact me?

The Medical Injury Compensation Reform Act ensures injured patients receive fair compensation, while stabilizing liability costs. Since the 1970s, when a medical malpractice insurance crisis led to MICRA’s passage, health care providers, including dentists, have been protected from extreme liability exposure and skyrocketing premiums by its various provisions, including the $250,000 cap on speculative noneconomic damage awards. The cap reduced incentives by trial lawyers to file meritless lawsuits that drive up health care costs.

In fact, TDIC, The Dentists Insurance Company, was born out of the time period when dentists and other health care providers were at the mercy of increasing annual premiums, which were rising from 100 to 400 percent due to litigation of claims and huge monetary settlements.

Who is behind the effort to change MICRA?      

Trial lawyers have launched a campaign to collect signatures to qualify their initiative, “The Troy and Alana Pack Patient Safety Act,” for the November 2014 ballot. The measure, as it would read on the ballot, requires alcohol and drug testing for doctors, among other things, but that is only window dressing to camouflage its true purpose — to change provisions of MICRA. The measure would raise a cap on noneconomic damages from $250,000 to $1.1 million, which would increase health care costs, reduce access to care and allow trial lawyers to make more in legal fees.

County and state hospitals pay medical malpractice awards out of the budgets they receive from taxpayers. The nonpartisan Legislative Analyst’s Office estimates that lifting the MICRA cap would cost local governments and the state hundreds of millions of dollars annually that are currently spent on public safety, protecting the health care safety net and clinical care.

This effort to change MICRA is occurring at the same time the state is implementing federal health care reform (ACA), which has brought coverage to millions of additional Californians. Higher costs that could result from trial lawyer-sponsored changes to MICRA would likely increase operating costs for doctors, hospitals and community clinics, jeopardizing the ability of providers to take on more patients.

What is CDA doing to protect MICRA?

CDA and partners in the coalition, Californians Allied for Patient Protection (CAPP), are working to defeat the initiative. The CAPP coalition has established a campaign committee, which has more than $30 million in the bank to fight the initiative if it ends up on the ballot with additional commitments in the tens of millions. CAPP is actively engaged in efforts to educate the public through the media and newspaper editorials.

Last year, CDA and CAPP successfully thwarted an effort by trial lawyers to pressure lawmakers into changing the law through the legislative process by communicating to legislators the importance of maintaining current provisions of MICRA. 

When do we find out if our efforts to defeat the initiative are successful?

The trial lawyers must collect approximately 500,000 valid signatures and turn them in by March 24. The Secretary of State and county election offices have several months to determine if there are enough valid signatures to force the issue on the November ballot.

With the future of our profession at stake, MICRA is moving to dentistry’s front burner, and I want you to know this organization and its partners are working hard to defeat this initiative.

For more information, type “MICRA” in the search box on cda.org.