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F I S C A L I M P A C T R E P O R T
SPONSOR Komadina
ORIGINAL DATE
LAST UPDATED
01/28/08
HB
SHORT TITLE Continue Obstetric Health Care Task Force
SM 1
ANALYST Hanika-Ortiz
ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT (dollars in thousands)
FY08
FY09
FY10 3 Year
Total Cost
Recurring
or Non-Rec
Fund
Affected
Total
$.01
(Parenthesis ( ) Indicate Expenditure Decreases)
SOURCES OF INFORMATION
LFC Files
Responses Received From
Health Policy Commission (HPC)
SUMMARY
Synopsis of Bill
Senate Memorial 1 requests the New Mexico HPC continue the work of its task force on
obstetric health care practitioner liability insurance to find solutions to the continuing crisis in
obstetric health care.
The Memorial includes all health care practitioners that practice in obstetrics.
The Memorial further recognizes that there is a continuing crisis in obstetric health care access
due to escalating malpractice premiums. The escalating costs threaten access to childbirth
services, especially in underserved and rural areas where certified nurse-midwives provide many
services. The Memorial further confirms that one-third of all vaginal births in New Mexico are
delivered by certified nurse-midwives.
The Memorial proposes that the task force submit its findings and recommendations by October
2008 to the Legislative Health and Human Services Committee, the Legislative Finance
Committee, and the Office of the Governor.
FISCAL IMPLICATIONS
There will be costs to State agencies and others (as requested) to provide staff time to participate
on the task force.
pg_0002
Senate Memorial 1– Page
2
SIGNIFICANT ISSUES
In October of 2007, the HPC published the Childbirth Injury and Obstetrical Liability Insurance
report, which identified the issues regarding obstetric health care access due to the escalating
malpractice premiums. The information collected by the task force indicates that this is an issue
throughout the entire State, especially for rural areas where there are fewer care options.
The following was provided by HPC:
Findings on Medical Malpractice Insurance
The task force has found the following regarding the cost and availability of professional liability
coverage for providers of obstetrical services in New Mexico:
•
Problems with the cost and availability of medical malpractice insurance are experienced
primarily by those certified nurse midwives (CNM) who do births and are not employees
of large systems.
•
Obstetrician practices that employ CNMs confirmed to commission study members that
the cost of CNM malpractice insurance to the practice has increased substantially and
may threaten the practices ability to maintain them as employees.
•
Professional liability insurance is unavailable to licensed midwives who provided care for
most of the 1% of New Mexico births that occur in the home. Those providers who
perform home births do so at their own legal and financial risk.
•
For licensed midwives who work in birthing centers, professional liability insurance is
available from only one company, whose rates are unregulated, and at a cost that is
rapidly increasing and threatens the ability of licensed midwives to stay in business.
•
For CNMs in private practice or in small clinics, professional liability insurance is
available primarily from one company, whose rates are unregulated, and at a cost that is
rapidly increasing and threatens the continued economic viability of CNMs.
•
Professional liability insurance remains available in New Mexico, at a substantial though
relatively stable cost, for most independent Obstetrician/Gynecologists and family
Doctors who perform deliveries.
•
The proportion of malpractice insurance premiums written by carriers on surplus lines
increased from 15.0% in 2002 to 36.0% in 2006 for providers other than physicians and
surgeons in New Mexico. These carriers are not subject to regulation under New Mexico
insurance laws.
•
Data is not available to the commission task force concerning the extent to which cost of
obstetrical malpractice insurance, settlements and suits has influenced business costs for
large governmental and corporate organizations.
PERFORMANCE IMPLICATIONS
The HPC will provide staff for the Obstetric Health Care Practitioner Liability Insurance Task
Force. The HPC staff will also provide resources and assist in the development and writing of
the Task Force’s findings and recommendations.
CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP
Duplicates HM 9
pg_0003
Senate Memorial 1– Page
3
WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL
The HPC believes it may be unable to continue to pursue solutions to the continuing crisis in
obstetric health care due to liability insurance.
POSSIBLE QUESTIONS
Who else sits on the task force other than HPC staff members.
AHO/mt