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Lawmakers, lawyers, and patient advocates agreed Wednesday on proposed legislation that would increase California’s medical malpractice pain and suffering limit from the current maximum of $250,000 set in 1975.

The Los Angeles Times reports that the overhaul to the long-standing Medical Injury Compensation Reform Act of 1975, known as MICRA, with the deal requiring that it be signed into law by Gov. Gavin Newsom before June 28 – the deadline for removing a related measure from the Nov. 8 statewide ballot.  

This year’s ballot measure, if approved by voters, would have eliminated MICRA protections by creating a broad new category of lawsuits under which no cap on noneconomic damages or attorneys’ fees would apply.

California’s existing medical malpractice cap imposes a $250,000 limit on how much patients can be awarded for damages that are not directly related to medical bills and economic losses, such as lost earnings. But critics have argued that a cap on awards for pain and suffering severely limits how much injured children, retirees and stay-at-home parents can receive while also deterring attorneys from taking on the complex cases.

The revised framework under the negotiated agreement, reached after several weeks of intense negotiations between attorneys and doctors groups, includes several provisions that would update MICRA while continuing its medical liability protections. The most central provision would change the limits on noneconomic damages from the current $250,000 to:

– – Cases not involving a patient death: $350,000 starting Jan. 1, 2023, with an incremental increase over the next 10 years to $750,000.
– – Cases involving a patient death: $500,000 starting Jan. 1, 2023, with an incremental increase over the next 10 years to $1 million.
– – After 10 years, an annual 2% adjustment would apply to the limits.
– – These new limits would only apply to cases filed Jan. 1, 2023, or later; they would not apply retroactively.

“This agreement signals the end to one of the most longstanding battles in California politics, and strikes a fair balance protecting patients, while ensuring that physicians and other medical professionals can treat patients without fear of financial ruin,” Newsom said in a written statement. “This is an important victory for the stability and health of our healthcare system, and for patients across California.”

The agreement will be contained in amendments to AB 35 which sidesteps what would have otherwise been a bruising and expensive political fight. A ballot measure, if approved by voters, would have required non-economic damages in medical malpractice lawsuits to be tied to inflation dating back to 1975 while allowing judges and juries to award damages above the cap in cases where a person dies or is permanently and physically impaired, disfigured or disabled.

The decision to withdraw the measure in favor of action by the Legislature is notable. Prior to 2014, a statewide initiative was required to be on the ballot once voter signatures had been submitted and verified. Lawmakers changed the rules in an effort to spark more compromises instead of costly and often confusing political campaigns.

Efforts to increase the malpractice cap in 2014 almost became the first test of the new ballot measure rules, but a compromise failed and a MICRA overhaul ballot measure, Proposition 46, was overwhelmingly rejected by voters.

In December, a Times investigation found that since 2013, the Medical Board of California has reinstated 10 physicians who had lost their licenses for sexual misconduct. They included two doctors who abused teenage girls and one who beat two female patients when they reported him for sexually exploiting them. In addition, The Times found that the board had consistently allowed doctors accused of negligence to keep practicing and harming patients, at times leaving them dead, paralyzed, brain-damaged or missing limbs.

Lawmakers are currently weighing several legislative proposals to overhaul the state medical board, including a bill to permanently ban doctors convicted of sexually abusing patients and another that would change the makeup of the medical board to a public-member majority.