13 Nov Is PACA is a Win-Win for Patients and Pain Management Providers?
Dr. Nikesh Seth and his team stay on top of the latest medical news that might impact pain management, including the recent look at PACA. The Protecting Access to Care Act (PACA) of 2017, sponsored by Representative Steve King and known colloquially as the common sense liability form, is stirring up excited murmurs in medical circles. It was inspired by the Medical Injury Compensation Reform Act (MICRA) in California, which is considered a big success. MICRA has been called mutually beneficial for both providers and patients.
PACA is designed to reform medical liability laws and minimize “defensive medicine”—an incredibly expensive practice. It was created so that patients are fairly compensated for medical injuries, keeping those awards out of the pockets of attorneys. To sweeten the deal, PACA also has potential to save billions of dollars in taxpayer money. Better yet, it will help speed up health care access.
How Does PACA Work?
At the heart of the bill is appropriate compensation for patients, inclusive of all damages. PACA ensures both past and future expenses are included in awards, which encompasses lost earning potential and past wages, cost of rehabilitation, and other expenses. There’s also a $250,000 option for non-economic losses like pain and suffering.
Also, the court will be granted the power to confine any patient awards that could previously be earmarked for contingency or lawyer fees. The fee is capped at around 20% of an award. This ensures attorneys still get a generous fee for their work, but the patient reserves the majority of the award. PACA was created to marry lost costs without impacting the patient’s well-being.
“Defensive medicine” is a byproduct of a lawsuit-happy culture. Some medical professionals may order costly tests, CT scans or other treatments in order to protect themselves from potential lawsuits—even when there is little or no evidence to back up such orders. PACA estimates that defensive medicine costs up to $289 billion each year. According to the Congressional Budget Office, a non-partisan office, the bill has the potential to save taxpayers $44 billion in the next ten years just in Medicare and Medicaid alone. Ultimately, this means lowering the national debt by nearly $50 billion in that same timeframe.
Doing the Math With Medical Claims
Since 68% of medical liability claims are dismissed, withdrawn or dropped and 88% of those that do end up in a trial are awarded to the providers, it’s a costly game for practitioners. It’s very expensive for a physician to act as a defendant in such claims, and PACA means medical liability insurance premiums would be drastically reduced. In some cases, surgeons have even chosen not to undertake surgeries solely due to litigation fears—which had led to a lack of qualified professionals for patients in need.
PACA also offers protection and customization options for states that already boast similar, effective programs. As this bill unfolds, you can count on Dr. Nikesh Seth and the team at Integrated Pain Consultants by booking your appointment online or call us at (480) 626-2552.