Colorado’s Health Care Availability Act

Gerald Zarlengo, MD, Chairman & CEO, COPIC Insurance Company

Editor’s note: Recent changes to medical liability laws in other states underscore a movement of change. The Colorado Medical Society is aware, engaged and actively working to ensure Colorado’s stable medical liability climate remains. CMS and key partners like COPIC will continue to promote patient safety and the importance of liability protections. Physicians should be aware of what current protections are and how they came to be. If you have questions, please do not hesitate to contact Chet Seward, CMS Chief Strategy Officer, at chet_ seward@cms.org or 720-739-5456

The Health Care Availability Act (HCAA) was a major tort reform package passed by the state legislature in 1988 with bipartisan support. These reforms struck a balance to ensure Colorado citizens have access to both high quality health care providers as well as fair compensation if they are harmed due to negligence. The HCAA was crafted after years of a destabilized, under-regulated tort environment that caused Colorado’s health care providers to experience unpredictably large awards resulting in skyrocketing, unsustainable medical liability insurance premiums in the early 1980s. This resulted in providers being forced to either leave the state and practice medicine elsewhere, eliminate high-risk services from their practice, or fight for reforms to protect their ability to provide needed care to the patients of Colorado. They chose to fight.

The HCAA established a key statutory structure to govern medical malpractice litigation. While the HCAA was modeled after other states also responding to a similar crisis, the brain-trust behind HCAA baked in many reforms that are unique to Colorado. It is due to this thoughtful, multi-pronged reform package that Colorado’s tort environment has been able to withstand legislative and legal attacks over the last 35 years. Several major pillars of tort reform within the HCAA that are most familiar include:

• Financial liability requirements (e.g. mandating medical liability insurance coverage);

• Limitations on damages (e.g. caps on non-economic damages);

• Establishing judicial procedure (e.g. expert witness standards, disclosure of evidence and judgements, and peer review protections); and

• Limitations on actions (e.g. statutes of limitation, corporate practice of medicine, governmental immunity).

Health care professionals consider a state’s medical liability environment when considering where to practice. Maintaining a stable, balanced tort environment is crucial to the recruitment and retention of quality physicians and to provide accountability and protection for patients who are injured during the course of care. Having fewer health care providers practicing in Colorado means longer wait times, greater distances traveled to reach providers, fewer specialist providers, and higher costs.

Medical liability reforms such as the HCAA help protect patients and the medical community from increasing health care expenses, which is particularly important in underserved communities where quality, affordable health care is at a premium and providers operate on narrow margins. The reforms not only give providers a sense of stability in their practice, but they also allow the medical community to focus their attention and resources on delivering quality care to their patients.

COPIC’s founders helped fight for the HCAA alongside the Colorado Medical Society and have worked to uphold these important reforms over the last 35 years. History has demonstrated that reasonable, thoughtful tort reforms create balance between protecting patients and attracting health care providers. ■