Providers applaud medical malpractice provision in the Sustainable Growth Repeal bill

Between late March and mid-April 2015, both the House and the Senate voted to repeal the Sustainable Growth Rate formula for physician reimbursement under Medicare, and President Obama has signed the bill, known as the “Medicare Access and CHIP Reauthorization Act of 2015.”

A little-noticed provision in the new bill, however, will offer providers more protection from medical malpractice lawsuits. The bill requires the government to measure the quality of care clinicians provide and rates their performance on a scale from zero to 100. It also stipulates that the quality of care standards used in federal health programs cannot be used in malpractice cases.

Providers have been concerned that quality metrics, such as those mandated by the Affordable Care Act, pose unintended legal risks for health-care practitioners, and that patients and attorneys will use such data in court to show medical negligence. The malpractice provision of the new bill protects clinicians from this.

The exact wording of the provision is as follows:

“The development, recognition, or implementation of any guideline or other standard under any Federal health care provision shall not be construed—(A) to establish the standard of care or duty of care owed by a health care provider to a patient in any medical malpractice or medical product liability action or claim.” 

Medical groups have said that federal standards don’t accurately reflect the standard of care in a medical malpractice case and shouldn’t be used in malpractice lawsuits. Expert testimony should be used, as always, to establish what the standard of care is and whether it has been breached, they argue.

American Medical Association President, Robert Wah has said that federal quality measures “should not be exploited to invent new legal actions against [practitioners].”