Month: March 2025

In the background of a chaotic legislative session, several bills designed to strengthen legal protections for medical providers, health care systems and insurance companies faced with malpractice claims are sailing smoothly through committee votes and floor debates on their way to the governor’s desk.

The proposed changes to Montana’s malpractice legal landscape are backed by powerful players in the health care industry. One of the most prominent measures would stop medical malpractice cases and insurance payouts from being automatically reported to the state licensure board. Another would limit how juries can assess damages in malpractice cases.

Another bill aims to prevent the Montana Supreme Court from finding the state’s $250,000 cap for non-economic damages in malpractice cases — one the lowest limits in the country — unconstitutional.

The proposals would alter the state’s complex legal framework of health care oversight and recourse for injured patients. But they have received little to no public testimony from people outside the health care or legal fields during the first two months of hearings. Proponents have argued the legislation will help hospitals and providers weather expensive malpractice lawsuits and cut unnecessary bureaucratic oversight processes.

In a legislative session filled with lightning-rod issues — including property tax reform and Medicaid expansion — the industry-backed medical malpractice bills have mostly flown under the radar. A major exception has been bills that make it easier to sue doctors who provide gender transition-related care for trans minors and add a 25-year statute of limitations to pursue damages, proposals that have advanced despite receiving vocal opposition from members of the public and health industry advocates.

The other, lesser-known bills could bring about far-reaching consequences for health care oversight in Montana and patients seeking remedies for medical damages.

Closing a route for license complaints
The Montana Medical Legal Panel (MMLP), a group of providers and lawyers convened by the Montana Medical Association, is the first step required by law for medical malpractice cases.

There, patients, providers and insurance companies appeal to panelists to determine whether the case could indicate malpractice or patient injury, though the findings don’t prevent a person from suing later in district court or agreeing to an out-of-court settlement. Over the last decade of cases from 2014 to 2023, the panel reports receiving an average of 215 complaints per year. An annual average of 18% of those claims proceed to a lawsuit.

Separately, state licensing boards oversee the professional licenses of medical practitioners. Those boards investigate claims of unprofessional conduct and can suspend or rescind a person’s license. The state Board of Medical Examiners, which monitors the licenses of more than 16,000 physicians, physician assistants and other Montana health professionals, took adverse action against six licenses in 2023, the most recent year for which data is available.

By law, the two avenues for oversight converge only briefly after the MMLP makes a decision. A copy of that finding must be shared with the professional licensing board, which can choose to investigate further if it sees fit.

House Bill 442 would strike that mandatory referral from state law. The legislation, sponsored by Rep. Valerie Moore, R-Plentywood, would also repeal a legal requirement that insurance companies report medical negligence claims and settlements to licensing boards.

Republican Gov. Greg Gianforte’s commissioner of the Department of Labor and Industry, which oversees the Board of Medical Examiners and other medical licensing boards, testified in favor of the proposal, describing it as a way to cut unnecessary procedures and clear out red tape.

“Unnecessary complaints are a regulatory burden that we don’t need,” Commissioner Sarah Swanson said during a February committee hearing for HB 442, arguing that the referral system was “redundant and duplicative,” despite the two groups serving different oversight purposes.

Another bill proponent, a hospital administrator, said the change would protect providers from being dragged through licensure investigations when someone files a frivolous malpractice complaint.

“This type of automatic escalation does not serve patients, providers or the licensing system well,” said Nick Dirkes, the administrator at Frances Mahon Deaconess Hospital in Glasgow.

But other doctors involved in the oversight process have voiced misgivings about the proposed changes, though not through testimony before lawmakers.

During a January meeting of the Board of Medical Examiners, one member said he was considering testifying about HB 442, though as a private citizen rather than as a board member.

“By removing that requirement, it may delay the board being aware of and processing malpractice actions and substandard care by years,” said Dr. James Guyer, a family medicine practitioner from Billings, in comments to other board members. “And we’ve seen that. We’ve seen cases that come up eight years after [the] initial injury.”

Guyer did not testify during the bill hearing last month before the House Business and Labor Committee and did not reply to an emailed request for comment from Montana Free Press about his personal stance on the bill.

Without hearing from any opponents, the committee passed the bill unanimously. It cleared the House chamber in late February by a 97-2 margin.

After supporting the end to automatic referrals, Swanson appeared before the same committee again in February to propose opening a route for license complaints when former patients have already settled a malpractice claim.

House Bill 563 prohibits malpractice settlements from dissuading or prohibiting licensure complaints. Backers say it will allow former patients to seek professional accountability for a medical provider in addition to financial damages.

Swanson and her staff told the legislative committee that the idea behind the bill originally received pushback from hospital and insurance lawyers. She maintained that HB 563 would help licensure boards protect the public from bad actors.

“This is part of what makes [HB 442] OK,” testified Quinlan O’Connor, a labor department attorney, referencing the earlier bill to strike reporting requirements for the MMLP. “We’re gonna get it from people who are individually hurt. We don’t need somebody else reporting it to us.”

Changes to ‘the cap’ for malpractice damages
Another proposal en route to Gianforte’s desk would gradually increase the state’s $250,000 cap on non-economic damages in medical malpractice cases over the next four years and create an inflationary increase after that.

Critics of the cap, which has been in place since the 1990s, have long said that it is unconstitutional to limit how much juries are able to award claimants for emotional pain and suffering. Economic damages, such as medical bills and lost future wages, remain uncapped in Montana, creating a system that some plaintiff’s attorneys say allows wealthy claimants to recoup more for medical injuries than low-income people.

But the constitutionality of the cap has never received a legal determination from Montana courts. Cases that have gotten close to the question in recent years have ended in settlements. Jurors are not allowed to know that the non-economic damages they award are subject to a cap.

House Bill 195, sponsored by Rep. Bill Mercer, R-Billings, would increase the non-economic damages cap to $500,000 by 2029 in an effort to account for inflation. The bill was originally drafted by the Montana Medical Association, according to the public bill drafting file, with input from other health care industry lobbyists and defense attorneys.

Mercer, a private practice attorney who has defended health care entities, told MTFP his main motivation in bringing the bill is to defend the cap’s legitimacy and avoid it being deemed unconstitutional by state courts.

“The motivation is much more a concern of the medical provider community that they want a viable cap and they’re worried that the cap will be taken down,” Mercer said in an early February interview.

The bill has received broad bipartisan support in recent committee hearings, even as some legislators maintain that any cap violates Montanans’ right to recoup damages and have a fair jury trial.

“If you have a jury who heard all of the facts, heard all of the damages and decided to award more than this amount, then their decision is nullified,” said Sen. Andrea Olsen, D-Missoula. “Their time spent, their considerations were overruled.”

Olsen, also a practicing lawyer, ultimately voted in favor of the bill, noting that raising the cap at all was better than keeping it at its current amount.

Another piece of legislation sponsored by Mercer and drafted by the MMA and industry defense attorneys would restrict what juries can be instructed to consider in medical malpractice cases.

The bill is a direct response to a 2023 ruling by the Montana Supreme Court that allowed a jury in a medical malpractice case to consider the risk of procedures when assessing whether a provider exercised adequate caution.

Almost a year after that case, Camen v. Glacier Eye Clinic, P.C., defense attorneys and the Montana Medical Association began drafting legislation to legislatively reverse the Supreme Court finding. As outlined in House Bill 342, juries would be prohibited from calculating malpractice damages based on anything other than the standard of care as described by expert testimony.

In email exchanges attached to the bill drafting file, attorneys for hospitals, medical providers and insurance companies debated the breadth and scope of the possible changes.

“An attempt to fix what our Supreme Court did in Camen with respect to the greater danger/risk = greater care required, is important,” said Sean Goicoechea, a Montana-based attorney who represented Glacier Eye Clinic in the 2023 case, in a message to an attorney for Curi, a major medical insurance company. “However, we all need to understand our Legislature can be a bit unpredictable and, in my opinion, distractible. So, I favor keeping this clean and simple.”

The lawmaker who requested the bill, Rep. Steve Fitzpatrick, R-Great Falls, also an attorney, approved the language near the end of the drafting process.

The bill passed consideration by the House, though by narrower margins than other medical malpractice reform bills. It is now awaiting hearings in the Senate. Montana Free Press

The eradication of polio as a global health threat may be delayed unless US funding cuts – potentially totaling hundreds of millions of dollars over several years – are reversed, a senior World Health Organization official has warned.

The WHO works with groups such as UNICEF and the Gates Foundation to end polio. The planned withdrawal of the United States from WHO has impacted efforts, including stopping collaboration with the US Centers for Disease Control and Prevention. Last week, UNICEF’s polio grant was terminated as the State Department cut 90% of USAID’s grants worldwide to align aid with President Donald Trump’s ‘America First’ policy.

In total, the partnership is missing $133 million from the US that was expected this year, said Hamid Jafari, director of the polio eradication programme for the WHO’s Eastern Mediterranean region. The area includes two countries where a wild form of polio is spreading: Afghanistan and Pakistan.

“If the funding shortfall continues, it may potentially delay eradication, it may lead to more children getting paralyzed,” he said, adding that the longer it took to end polio, the more expensive it would be.

He said the partners were working out ways to cope with the funding shortage, which will largely impact personnel and surveillance, but hoped the US would return to funding the fight against polio.

“We are looking at other funding sources … to sustain both the priority staff and priority activities,” he said.

He said vaccination campaigns in both Afghanistan and Pakistan would be protected.

UNICEF did not respond to requests for comment, and a spokesperson for the Gates Foundation reiterated that no foundation could fill the gap left by the US Saudi Arabia gave $500 million to polio eradication last week.

The partnership already faces a $2.4 billion shortfall to 2029, as it accepted last year that it would take longer, and cost more, to eradicate the disease than hoped. Reuters

The United Nations has launched an emergency appeal to raise $11.2 million to help fund Uganda’s response to an Ebola outbreak that has killed two people, after the country’s health budget was strained by U.S. cuts to foreign aid.

Uganda declared the outbreak of the highly infectious and often fatal haemorrhagic disease in January in the capital Kampala after the death of a male nurse at the East African country’s sole national referral hospital.

A second Ebola patient, a four-year-old child, died last week, the World Health Organization said, citing the country’s health ministry.

Uganda’s 10 confirmed cases have been linked to Ebola’s Sudan strain which does not have an approved vaccine.

In a statement sent out on Tuesday, the UN said the funds would cover the Ebola response from March to May in seven high-risk districts.

“The goal is to rapidly contain the outbreak and address its impact on public health as well as associated social-economic life of affected people,” said Kasonde Mwinga, Uganda representative for the World Health Organization (WHO), a UN agency.

Uganda has traditionally relied heavily on the U.S. for its health sector funding.

During the last Ebola outbreak in 2022-2023, the United States provided $34 million to fund case management, surveillance, diagnostics, laboratories, infection prevention and control among other activities, according to a U.S. Embassy report.

But President Donald Trump’s administration imposed an aid freeze and U.S. funding to Uganda’s health sector has been slashed, hitting the country’s public health budget, according to government officials.

Uganda’s Health Ministry spokesperson, Emmanuel Ainebyoona, did not immediately respond to a request for comment.

Dr Janet Diaz from the World Health Emergencies programme told a Geneva press briefing after a trip to Uganda that the agency was already having to temporarily take on aspects of the Ebola response previously done by other groups due to the U.S. cuts. These include deploying surveillance teams at border points and the handling of biological samples.

Ebola symptoms include fever, headache and muscle pains. The virus is transmitted through contact with infected bodily fluids and tissue. Reuters

Arva Health has raised $1 million in pre-Seed funding, led various investors including All In Capital, iSeed, Bharath Founders Fund, and Galaxy. Currently, fertility care in India islargely fragmented, expensive, and weighed down by stigma.

However, Arva Health is creating a new standard in fertility care with its expert medical care, diagnostics, and personalised support under one roof. The start-up is founded by Dipalie Bajaj, and Nidhi Panchmal. Its first flagship clinic in Bengaluru’s Whitefield will provide fertility testing, consultations, egg freezing, and IVF in a modern setting.

“We are not in the business of diagnosing infertility but in the business of helping people have babies. By improving access and experience, we can dramatically improve outcomes for millions of people,” said Dipalie Bajaj, co-founder and CEO of Arva Health.

The start-up, in an official statement, claims that the funding will fuel the launch of India’s first network of tech-enabled fertility clinics, beginning in Bengaluru. The aim is to make reproductive care affordable, accessible, and free from stigma.

All In Capital founder Kushal Bhagia said, “We invested in Arva Health because infertility is becoming a huge problem in India. We believe that Arva Health represents the future of reproductive care tailored to contemporary women and couples-delivering healthcare that today’s patients deserve.”

Arva’s Fertility Care model
Unlike traditional fertility centers, Arva offers patient-first reproductive care. From at-home fertility testing and expert consultations to IVF, egg freezing, and fertility coaching, the start-up supports individual and couples at every stage of their fertility journey.

Arva Health cofounder Nidhi Panchmal believes that fertility care in India need a rebrand because people feel lost, rushed, or judged in this process. “We are building clinics that put patients first — where they feel heard, supported, and empowered every step of the way.”

Since its launch last year, Arva has helped over 4,000 women navigate their fertility, built a 40,000-member community, and scaled at 60% month-over-month. The healthcare start-up plans to open clinics in ten locations, including Mumbai and Delhi, by 2027. Additionally, the company intends to expand into men’s fertility services and develop a digital platform to offer continuous support for fertility. Outlook Business

The Health Department has initiated the process of establishing Trauma Care Centres (TCCs) across 14 districts in the state, with seven of these facilities planned for Faridabad and Palwal districts.

A senior official confirmed that the Union government has approved a budget of Rs 200 crore for the project, with Rs 175 crore already allocated for procuring medical equipment. The primary trauma care centre in each district will be located within the civil hospital premises, with some facilities extending to Community Health Centres (CHCs).

“An initiative of the Central Government, the scheme will be implemented within the existing infrastructure of government hospitals. These centres will provide immediate medical intervention to victims suffering from severe traumatic injuries caused by accidents, falls or violent acts. Timely treatment within the ‘golden hour’ is critical to maximising survival rates and minimising complications,” said a senior Health Department official.

The trauma care infrastructure will be developed in districts connected to National Highways and Expressways, including Faridabad and Palwal, which are slated to receive four and three centres, respectively.

With many critical patients currently being referred to Delhi due to the lack of advanced treatment facilities in the region, officials believe the delay in medical intervention has been a key factor in high casualty rates.

“The absence of well-equipped trauma centres has been a longstanding concern. Victims suffering from serious injuries are often transported to Delhi, leading to avoidable fatalities. The new centres will ensure that no trauma victim has to travel beyond 50 km for emergency care,” an official said on condition of anonymity.

SK Sharma, coordinator of the Road Safety Organisation (RSO), an NGO, echoed this concern. “Most government and private hospitals lack state-of-the-art trauma care. The 50-km rule for establishing trauma centres on highways is critical, yet Faridabad and Palwal have been left without this essential facility for years,” he said.

Similarly, Satish Chopra of NGO Sewa Vahan, who has been protesting for nearly three months demanding a trauma care centre, criticised the inadequate healthcare infrastructure. “The poor facilities at civil hospitals have turned them into mere referral centres for critically injured patients,” he said.

Dr MP Singh, an official of the Health Department, confirmed that work on the project has already begun and that the facilities are expected to be operational within a year. The Tribune

The Supreme Court on March 4, 2025 directed States to consider framing guidelines to ensure patients are not “exploited” or compelled by private hospitals to buy medicines, implants, consumables and medical devices at inflated prices from their own pharmacies or outlets.

The court, at the same time, cautioned the States from taking a hard line while formulating the guidelines that may affect private investment in the health sector.

A Bench headed by Justice Surya Kant took a balanced view that States, until they develop the infrastructure, would need private hospitals to fill in the gaps in their health sector.

“Not only people, but States look to private hospitals for providing basic and specialised service to the public at large,” the court noted.

The hearing was based on a plea filed by petitioner-in-person Siddharth Dalmia. Mr. Dalmia said in court that he had personally felt the brunt of the exploitation when a relative had undergone extensive treatment at a private hospital.

Refraining from commenting on the merits of Mr. Dalmia’s allegations of “exploitation” and unreasonable charges levied by private hospitals, the Bench said it merely wanted to sensitise the State governments to the situation. The court said the issue raised in the petition amounted to the taking of a policy decision. The subject of health and sanitation, hospitals and dispensaries were State subjects. The policy-makers of each State had to take a call on the measures they wanted to adopt, the court noted.

“It will not be advisable for the court to issue mandatory conditions that would hamper the establishment of hospitals by the private sector,” the Bench struck a cautionary note in its order.

Disposing of the petition, the court said it merely wanted to draw the attention of the States to the constitutional framework.

The court said the States and their policy-makers would be the best judges of whether they wanted to introduce a policy that would have a cascading effect on private investment in the health sector.

“Should the States, obliged to adopt economic policies dedicated to development of basic health infrastructure, take stringent measures in the meanwhile that may discourage private entities? These are policy decisions,” the Bench reasoned.

The court recorded Mr. Dalmia’s submissions that affordable medical assistance was important for one and all and amounted to protection of the fundamental right to life enshrined in Article 21 of the Constitution. Besides, Mr. Dalmia argued, States had a duty to ensure social and economic justice by providing all classes of citizens the requisite health infrastructure under the Directive Principles of State Policy of the Constitution. The Hindu