When President Barack Obama held the bipartisan summit on health care reform in February, one of the issues raised by Sen. Tom Coburn (R-OK) was a need for more efforts in tort reform, particularly in medical malpractice. Tort reform proponents have often argued that medical malpractice litigation has lead to costly "defensive medicine" and higher insurance liability premiums. Obama supported reform.

The Patient Protection and Affordable Care Act (PPACA) has measures to address medical liability. The Department of Health and Human Services (HHS) will award five-year demonstration grants to states for the development, implementation, and evaluation of alternatives to litigation. Fifty million dollars will be authorized for this initiative.

The grants are for state programs that have resolution for patients who have been allegedly injured by health care providers or organizations, while also promoting reduction of health care errors through collecting and analyzing data on patient safety.

The states that apply for the grants will need to demonstrate how a proposed alternative will make the medical liability system more reliable by increasing the availability of prompt and fair resolution of disputes. This includes:

--Encouraging efficient resolution of disputes;

--Encouraging disclosure of health care errors;

--Enhancing patient safety by detecting, analyzing, and helping to reduce medical errors and adverse events;

--Improving access to liability insurance;

--Fully informing patients about the differences in the alternative and current tort litigation;

--Giving patients the ability to opt out of or voluntarily withdraw from participating in the alternative at any time and to pursue other options;

--Not limiting or curtailing a patient's existing legal rights.

The state must also disclose the sources to fund compensation for any claims resolved under the proposed alternative, whether public or private. Funding should provide financial incentives for activities that improve patient safety.

HHS will give preference to states that have developed a proposed alternative after consultation with relevant stakeholders (patient advocates, health care providers and health care organizations, attorneys with expertise in representing patients or health care professionals, medical malpractice insurers, and patient safety experts). In addition, states that offer proposals for patient safety and reduced medical errors will receive preference in grants.

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