Legislative & MembershipCommittee Reportby Wayne Gravois, MD, Committee ChairAfter two Special Legislative Sessions, the 2006<strong>Louisiana</strong> Regular Legislative Session ended onJune 19, 2006. It was a fairly eventful session,with most <strong>of</strong> the emphasis on the aftermathrecovery <strong>of</strong> Hurricanes Katrina and Rita. Allhealth-care-related bills can be viewed by goingto the LSMS Web site at www.lsms.org andclicking on “Legislative,” then “2006Legislative Summary.” The majority <strong>of</strong> thesebills fall under the heading EmergencyPreparedness and Liability. The next section,entitled Environmental Health, deals with twosignificant laws — House Bill 1010 and SenateBill 742 — prohibiting smoking in both a vehiclewith a child and in public places. In additionto our efforts, these bills were strongly supportedby the American Cancer Society, among others.They are felt to be bold steps forward inreducing secondhand smoke’s ill effects.10Difficulties in the enforcement <strong>of</strong> these lawswere debated during committee and flooraction, but the lobbying efforts by all the supporterssuccessfully argued that this law hadbeen implemented in at least 10 other stateswithout any problems.The next section, Healthcare, contains a verysignificant piece <strong>of</strong> legislation that should impactus as family physicians and the future <strong>of</strong> famiymedicine in our state. HB 106, by Rep. Durand,extends the “sunset” date <strong>of</strong> the Interagency TaskForce on the Future <strong>of</strong> <strong>Family</strong> Medicine toSeptember 1, 2008, and also provided that onFebruary 15 <strong>of</strong> each year, the Task Force will presenta report on its findings and recommendationsto the secretary <strong>of</strong> DHH and the Legislature.HB 106 became Act 331 <strong>of</strong> 2006, effective onAugust 15, 2006. The task force, created in 2004,was designed to “assist DHH and other healthand human-service organizations in studying anddeveloping strategies to eliminate the significantprimary health care shortage in rural and urbanunderserved areas.” Please make the time toreview our LAFP Web site at www.lafp.org, andclick on <strong>Louisiana</strong> Interagency Taskforce onthe Future <strong>of</strong> <strong>Family</strong> Medicine for updates. Aspecial thanks to all <strong>of</strong> those volunteers servingon the committee, especially Drs. Ed Martin andRick Streifer. Many long hours have been spenttowards bettering our specialty <strong>of</strong> family medicine,and we still have a long way to go. As policyand design are formulated, we ask for yourinput and support.Under the next few sections, one <strong>of</strong> the mostcontroversial bills passed was SB 570, bySen. Hines, which provides for the economicand monopolistic protection <strong>of</strong> rural hospitalsand requires “ethical referral practices” byphysicians. Both the LAFP and the LSMSstrongly opposed this bill. Quoting the LSMSWeb site: “SB 570 severely impedes investmentand construction <strong>of</strong> certain health carefacilities by physicians or any ‘proposingparty’ in rural areas in direct competition withrural hospitals in their primary service area,which is defined as either a 25-mile radius orthe number <strong>of</strong> postal ZIP codes in which 75percent <strong>of</strong> the rural hospital’s patients reside.”The LAFP joined in the last-minute fight andnearly helped turn the tide. The bill wassqueezed out <strong>of</strong> the committee by one vote.In addition to the lobbying effort by our lobbyist,Jo Rose, we had one <strong>of</strong> our own ruralfamily doctors, Dr. Zeb Stearns, testifyagainst the bill. In order for the LAFP to be aforce, we need more active participation <strong>of</strong>our members in the legislative process in thefuture. We need to have physicians availablewho are willing to leave their busy practicesto testify. Having Jo Rose, our lobbyistdown at the legislature, certainly can help toexpedite things for those willing. This is OURacademy — YOURS and mine. We also needan updated Legislative Contact List <strong>of</strong>physicians so that we can quickly contactappropriate legislators. Please contactSonora or Linda Foster at OUR <strong>Academy</strong>Office with your contact information.Under the section Medical Malpractice,there were some rather ambiguous resolutionsthat were proposed. There was a “loser-pays”bill, SB 110, which appeared to be mostpromising but was opposed by LSMS andLAMMICO for fear that the physician defendantwould also be subject to penalty. I amstill waiting to understand that one. HB 412,by Rep. Johns, adds the donation <strong>of</strong> blood andblood products to the definitions <strong>of</strong> “patient,”“malpractice” and “health care” under privatemedical malpractice. LSMS opposed this, asthis expands the ever-increasing malpracticedefendant arena. As always, there was anunsuccessful attempt to “tinker” with ourmalpractice cap <strong>of</strong> $500,000. An importantbill that did not get much fanfare, but couldgreatly impact the present state <strong>of</strong> malpracticein our state, as we know it, is SB 406. We asphysicians need to understand this piece <strong>of</strong>legislation before agreeing to this with yourinsurance company. SB 406, by Sen. Lentini,provides, at the option <strong>of</strong> the defendant, aone-year expedited medical-review-panelprocess to issue an opinion beginning withthe appointment <strong>of</strong> the attorney chairperson.SB 406 became Act 323 <strong>of</strong> 2006, effective onAugust 15, 2006. The first 90 percent <strong>of</strong> thebill sounds very favorable to physicians andorganized medicine, but the last section iswhat concerns me. I quote:“The report <strong>of</strong> the expert opinion reached bythe expedited medical-review-panel processpursuant to the provisions <strong>of</strong> this Subsectionshall not be admissible as evidence in any
action subsequently brought by the claimantin a court <strong>of</strong> law. Neither party shall havethe right to call any member <strong>of</strong> the medicalreview panel as a witness. A panelist shallhave absolute immunity from civil liabilityfor all communications, findings, opinions,and conclusions made in the course andscope <strong>of</strong> duties prescribed by this Part.”I repeat: “The medical review opinion willnot be admissible in court.”In speaking with LAMMICO staff memberswho helped introduce the bill and the LSMSwho supported LAMMICO, it was theirunderstanding that the medical review opinionwas never supposed to be admissible when themedical review process was first formulatedback in the mid-’70s. I have not been able tocontact Dr. Donald Palmisano, who was aleader in the medical malpractice reform backin the ’70s, to verify this. I only know thatwith more than 85 percent <strong>of</strong> the review panelsfinding in favor <strong>of</strong> the defendant, unanimousfavorable decisions can mean somethingif the case goes to trial. I would be veryinterested in others’ opinions on this topic.There was a VICTORY for the uninsuredpatient this year that may have gone unnoticed.HB 1396 (originally HB 896) passedand was signed into law by the governor.This bill “Provides for physician discountsfor rendered health care services to theuninsured.” For much too long, we havebeen forced to charge all patients, bothinsured as well as the uninsured, the samefee for services rendered, while only receivingthe discounted fee from the insurer.MONROE FAMILY PRACTICEFOR SALEWell established, lucrative family practice located inGarden District <strong>of</strong> Monroe, <strong>Louisiana</strong>.Office equipment, medical equipment, waiting roomfurniture — everything needed to step in and beginpracticing immediately — is included in the sale.• Reason for sale:• Seller Finance:• Practice:RetiringMPOver 5,000 patientsPlease contact Brenda at (318) 322-1417 forinformation on this great opportunity in Monroe.Perfect Places & Properties7254cI would like to take this opportunity to thankeveryone for their help this last year — in particular,those on the Membership and LegislativeCommittee; the Executive Committee, led by Dr.Kim LeBlanc; Sonora and Linda, with the academy<strong>of</strong>fice; and a VERY SPECIAL THANKS toJo Rose, for her serious contribution to the cause.Lastly, if you would be interested in serving onthe Legislative and Membership Committee,please contact the LAFP <strong>of</strong>fice at www.lafp.orgor me at wgravois@lanermc.org. Participation ismuch easier now with conference calling and thee-mail system. Please support YOUR society.11
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