Opinion ID: 1697052
Heading Depth: 1
Heading Rank: 4

Heading: Legislative History of the MLSSA and Analysis

Text: As originally enacted, the MLSSA specified that medical malpractice lawsuits against state health care providers were to be filed against the state alone and that the state assumed [the state health care provider's] liability and defense costs. See Sibley, 477 So.2d at 1101; see also Ruiz, 1997-2412 p. 5, 713 So.3d at 445 (a suit for that [state health care provider's] malpractice could be instituted solely against the state and defended by the state, with the state paying any damages awarded in the suit.). The enacting legislation, Acts 1976, No. 66, provided in pertinent part: B.... Any suit arising out of any act of malpractice by a person covered by this Part shall be instituted solely against the state, defended by the state and the state shall be liable for any attorney's fees, costs, and expenses incurred and for damages awarded by a judgment of court or by compromise reached after institution of suit. (Emphasis added) In that same year, the Public Act was amended. [5] The minutes of the legislative committee considering the amendment reflect [t]he bill would allow joinder of person alleged to have committed malpractice as defendant, but without liability. [6] The amendment, contained in Acts 1976, No. 660, provided: C. Notwithstanding any other provisions of the law to the contrary, any health care provider (person as defined herein) acting within the course and scope of his employment, health care facility staff appointment or assignment for or on behalf of the State to any health care institution whether or not he receives compensation for such services, shall not be held liable for any amount of damages in excess of 500,000 dollars plus interests and costs for any injury or death of the patient due to any alleged act of malpractice within the course and scope of such employment, staff appointment, or assignment. The State shall pay from the State Health Care Provider Fund created by Subsection A of this section any costs of legal defense and damages awarded by judgment of a court or by a compromise after institution of a suit for a medical malpractice claim or claims against such health care provider (person as defined herein) not to exceed 500,000 dollars plus interests and costs. D. Any such judgment, settlement or compromise, including any costs of legal defense, rendered against any health care provider, as defined herein, shall be paid by the State of Louisiana. (Emphasis added) Of this amendment, this Court has previously stated that Act 660 of 1976 superseded [Act No. 66] by providing that a person providing health care on behalf of the state would not be liable for damages in excess of 500,000 dollars plus interests and costs for any injury or death of a patient due to malpractice, and that any judgment rendered against a health care provider would be paid by the state. Sibley, 477 So.2d at 1101; see Ruiz, 1997-2412 p. 5, 713 So.2d at 445 (The amendment ... changed the provision that the malpractice suit must be instituted solely against the state and instead allowed damages to be awarded against a covered Person, while limiting his liability to $500,000 and providing the state shall pay that judgment subject to the $500,000 limitation.). Thus, after its first amendment, the Public Act provided that lawsuits could be filed against the individual state health care provider, that a judgment could be rendered against an individual state health care provider, and that the state would pay any judgment rendered up to $500,000, plus interest and costs. In 1977, the legislature approved an amendment to allow the state to file an incidental demand against a state health care provider or his medical malpractice insurer for reimbursement or indemnification for costs paid after a judgment in a malpractice action had become definitive. See Acts 1977, No. 744; Sibley, 477 So.2d at 1101. This provision was suspended, however, by House Concurrent Resolution No. 49. See R.S. 40:1299.39 Historical and Statutory Notes; Sibley, 477 So.2d at 1101. At this time, the legislature also amended Subsection (D) to provide that the state would pay any judgment rendered against any health care provider by legislative appropriation. In Acts 1978, No. 611, the legislature rewrote portions of the Public Act regarding the limitation of liability and coverage, as follows: B. Limitation of liability. Notwithstanding any other provisions of the law to the contrary, no judgment shall be rendered, and no settlement or compromise shall be entered into for the injury or death of any patient in any action or claim for an alleged act of malpractice in excess of five hundred thousand dollars plus interests and costs. C. Coverage. Notwithstanding any other provision of the law to the contrary the state shall pay any damages, interest, cost of investigation and defense, and any other costs in connection with any claim [7] lodged against any health care provider (person as defined herein) for an alleged act of medical malpractice, resulting in the injury or death of a patient up to the limits set forth in this Part.... (Emphasis added) This 1978 amendment added new subsection (D), which provided that all malpractice claims against the state would be submitted to and administered by the Division of Administration of the state. Subsection (D) authorized the Division of Administration to investigate each malpractice claim, assemble all relevant data and coordinate with legal counsel designated by the attorney general for the defense of such cases. The Division of Administration was given the authority to compromise and settle any suit or claim up to the $500,000 limit and to pay all defense and investigative costs, and any other costs incurred in connection with the defense of these actions as they accrued. A new subsection (G) was added which provided that [a]ny person covered by this Part shall be considered as a named insured, and the coverage provided herein shall be primary. Acts 1986, No. 965 added the requirement to the Public Act that all malpractice claims against state health care providers which were not compromised or settled must be reviewed by a state medical review panel, and enacted LSA-R.S. 40:1299.39.1, which set forth the procedures and requirements for state medical review panels. Together, R.S. 40:1299.39 and R.S. 40:1299.39.1 comprise the complete procedure for the review and adjudication of medical malpractice suits involving the state and state health care providers. Reading these statutes in pari materia as they existed in 1986, their language evinced the legislature's clear intention that individual state health care providers would be named as defendants in medical malpractice lawsuits. The following emphasized language of R.S. 40:1299.39.1, as originally enacted, supports this conclusion. Subsection (A)(2)(a) provided that the filing of the request for a review of a claim would suspend the time within which suit must be instituted ... in the case of the state or persons covered by this Part. Subsection (B)(1)(a)(i) stated that [n]o action against the state, its agencies, or a person covered by this Part, or his insurer, may be commenced in any court before the claimant's complaint has been presented to a state medical review panel established pursuant to this Section. Subsection (B)(1)(b) provided that if an opinion was not rendered within a stated period of time, suit may be instituted against the state or a person covered by this Part. Subsection (B)(3) suspended the running of prescription with respect to the state or person until a specified time. Thus, in 1986, when the legislature initially required medical malpractice claims against state health care providers to be first reviewed by state medical review panels, the legislature clearly intended that medical malpractice lawsuits would be filed against individual state health care providers covered under the Public Act. In 1988, the Legislature added a new definition to the Public Act. Acts 1988, No. 786 added Subsection (A)(9) to R.S. 40:1299.39 which defined the [r]ight to recover losses due to malpractice as: the substantive right in favor of a patient or his representative to receive, subject to the fiscal legislative discretion of appropriation, some measure of compensation in money or services or both from the state as and to the extent allowed by this Section, toward repairing any injury or losses proximately caused to him by an act of malpractice committed by a state health care provider as defined in this Section. [Emphasis added] This addition was consistent with the other subsections of the Public Act which stated that it is the state alone from whom a successful malpractice claimant may recover damages or loss for the medical malpractice of a covered state health care provider. More important to our inquiry here, the 1988 act amended Subsections C, D and G to substantially their current forms. [8] At the same time, the act re-enacted all of the provisions of R.S. 40:1299.39.1 cited above as they were originally enacted. Thus, although the legislature rewrote the language establishing the right of recovery in Subsections C and D of R.S. 40:1299.39, with the effect that these subsections no longer described against whom lawsuits may be filed, it did not change the provisions of R.S. 40:1299.39.1 which clearly detail that lawsuits may be filed against the covered state health care providers. Later amendments to R.S. 40:1299.39.1 have not changed the cited language. [9] Considering the legislative histories of R.S. 40:1299.39 and R.S. 40:1299.39.1, we hold that a plaintiff may name an individual state health care provider covered under the Public Act as a defendant in a medical malpractice lawsuit. The practical effect of our holding is that the plaintiff will be able to treat the covered state health care provider as a party, instead of a witness, and will enjoy the corresponding discovery and evidentiary benefits of this distinction. We believe this effect comports with the legislature's intent to provide a patient/plaintiff with a special substantive sui generis statutory right to recover losses due to medical malpractice committed by a state health care provider. [10] Providing a right to recover losses due to the medical malpractice of state health care providers is but one legislative goal of the Public Act. In addition, the [MLSSA] was passed to insure an adequate supply of physicians and other professionals providing health care services on behalf of the state (1) by prohibiting judgments based on an act of such a person's malpractice in excess of $500,000, exclusive of medical expenses; and (2) by providing the state shall pay the judgments and costs of defense associated with such malpractice. Conerly, XXXX-XXXX p. 9, 714 So.2d at 714; Ruiz, 1997-2412 p. 7, 713 So.2d at 446-447; Sibley, 477 So.2d at 1100 and 1102. Although we hold that a plaintiff may name as a defendant an individual state health care provider covered under the Public Act, a judgment entered against an individual state health care provider in favor of a successful medical malpractice claimant would be inharmonious with the express language of the MLSSA. If it were otherwise, state health care providers would not be protected by the very act which was specifically intended to protect them from liability from judgments. The language of the MLSSA clearly provides that it is the state alone from whom a successful claimant may recover damages or loss for the medical malpractice of a covered state health care provider. Moreover, the legislative aim of ensuring an adequately supply of state health care professionals would be frustrated if judgments were entered against state health care providers. The essence of the MLSSA is that a person qualified or covered under the Public Act is insulated from being cast in judgment. As was stated in Ruiz , the entire purpose of the MLSSA was to entice professionals to provide health care to patients on behalf of the state by protecting them against malpractice judgments. Id., 1997-2412 p. 10, 713 So.2d at 448 (emphasis added). As was argued by the state before this Court, if judgments are entered casting both the state and the individual state health care provider as liable for damages, the covered worker would suffer real harm even though it is the state who would ultimately indemnify the state health care provider. The practical consequences of casting a state health care provider in judgment jointly with the state are succinctly described by the dissenting opinion in Landry v. Leonard J. Chabert Medical Center, [11] with regard to state-employed physicians: To allow the physicians to be cast in judgment jointly with the State renders the protection afforded by the act to be meaningless. It is no consolation to declare that they suffer no harm because they will be indemnified by the State. The recordation of the judgment will place a judicial mortgage on all of their real property, thereby preventing a sale of the physicians' real property unless the judgment were paid out of the proceeds. They would be unable to purchase any real property, as the judgment would prevent a lender from financing the purchase. Their salaries could be garnished and their other assets seized. Since the assets of the State are exempt from seizure, and should the State delay in satisfying the judgment for fiscal or other reasons, there would be nothing to prevent the judgment holder from proceeding to execute his judgment against all of the assets of the physicians that are not exempt from seizure. The intent of the Act, to protect them from malpractice judgments in order to entice health care providers to work for the state, would be frustrated. Thus, we hold that in a medical malpractice suit brought against the state and a qualified state health care provider, if the court finds the state health care provider committed medical malpractice, judgment must be entered for the successful claimant against the state alone. [12]