Utah House approves first substitute of HB503 after debate; amendment requires $1 million minimum malpractice policy

Salt Lake City — The Utah House of Representatives on Feb. 28 passed the first substitute to House Bill 503, a measure changing elements of the state's medical malpractice framework, by a 41'to'25 vote after extended floor debate and the adoption of an amendment requiring providers to maintain at least $1,000,000 in malpractice insurance to preserve protection for personal assets.

The bill's sponsor, Representative Hall, told colleagues the substitute removes a cap on damages, alters attorney-fee provisions tied to pre-litigation review panels, requires claims to be processed first through a provider's malpractice insurer before a hospital or clinic's coverage is tapped, and establishes a data collection effort beginning in April to track suits, settlements and panel findings. "This bill is fundamentally about doing what we can to lower health care costs and increasing access for all Utahns," Hall said.

Lawmakers and witnesses have debated whether rising malpractice litigation drives health-care costs and prompts providers to leave practice. Supporters argued the changes would reduce frivolous suits and help retain doctors and nurses; opponents said parts of the substitute would make it harder for seriously injured patients to obtain full compensation.

Most of the substantive floor amendments and debate centered on three topics: the role and findings of the pre-litigation panel, the risk that attorney-fee allocation could penalize plaintiffs who prevail on some claims but not others, and protections for provider personal assets.

Representative Hall described revisions in the substitute including a provision that, when courts or juries calculate awards, those calculations should use amounts actually paid rather than billed amounts. Hall said the substitute also includes a mechanism by which plaintiffs who proceed after an unfavorable pre-litigation panel finding must obtain a specialist's written opinion attesting to the case's merit to avoid potential exposure to opposing attorney fees. "We're gathering data on all of the suits that happened, the ones that settle, the ones that go to court, the ones in which the panel came back non-meritorious," Hall said, adding the data will inform future decisions.

Several lawmakers described the human and workforce impacts of malpractice pressures. "I'm I just received an email yesterday from a surgeon who said he is retiring three or four years early because he's done with being sued," Hall said. Other supporters cited figures offered on the floor: the House sponsor said malpractice payouts have risen more than 440% over the last 10 years; a member referenced a hospital association estimate that the state is short roughly 500 doctors and about 3,000 nurses.

Opponents questioned whether the substitute unduly limits injured patients' recourse. One Representative warned that a plaintiff who goes through the pre-litigation panel, is told the claim lacks merit, then prevails on several claims at trial could still face an award of opposing attorney fees that diminishes net recovery. "The only thing that comes from this is that it becomes even harder for somebody who's been seriously injured to be able to recover," said a member during debate.

After debate, Representative Dunigan moved and the House adopted Amendment 1 to the first substitute. Dunigan said the amendment bars a plaintiff from pursuing or executing a judgment against a provider's personal income or assets unless a court finds the provider's conduct was willful, malicious or intentionally fraudulent, or the defendant failed to maintain a malpractice insurance policy with a limit of at least $1,000,000. The amendment also removed a change to the existing law concerning "life care plans," leaving current law on that topic intact, the mover said.

Members also debated procedure. Representative Stoddard unsuccessfully moved to "circle" (postpone) the substitute, arguing the substitute had been posted only minutes before and had not had time for public input. Other members opposed postponement, saying the bill had been vetted in committee and a substitute reflected negotiated compromises.

After the House adopted Amendment 1, leaders called for final passage. "First substitute, HB 503, passes this body with 41 yes votes, 25 no votes and will be sent to the Senate for its consideration," the clerk announced.

What the bill does and what remains contested: The first substitute removes a cap on damages that had been a focal point of prior debate; modifies how attorney-fee awards and pre-litigation panel outcomes interact with subsequent litigation; requires insurers to be the primary payor for malpractice claims before other institutional coverage; and starts a state-mandated data collection on malpractice claims to be used for future policy decisions. Opponents said elements such as the affidavit requirement and attorney-fee exposure risk discouraging meritorious suits and could limit recovery in complex, high-cost injury cases.

Floor debate included questions about the composition of pre-litigation panels. Some members stated the panel includes a layperson, a medical provider and an attorney; others said they had been told there is no legal expert. One member later said a lobbyist had clarified there is a legal person on the panel. The substitute does not itself change the panel composition, the sponsor said.

The House's passage sends the amended first substitute of HB503 to the Utah Senate. No Senate action was recorded in the House transcript. The bill includes reporting and data provisions that sponsors said are intended to inform future legislative action.

Votes at a glance

- Motion to encircle HB503 (earlier procedural motion): moved by Representative Hall; outcome: passed on the floor (voice). - Motion to adopt first substitute HB503: moved by Representative Hall; outcome: passed before the body (voice). - Amendment 1 to first substitute HB503: moved by Representative Dunigan; outcome: adopted (voice). Amendment adds $1,000,000 minimum malpractice-insurance requirement to preserve protection for personal assets and retains current law on life-care plans. - Final passage of First Substitute HB503: outcome: approved 41 yes, 25 no; will be transmitted to the Senate.

Next steps

The measure, as amended, will proceed to the Utah Senate for consideration. Sponsors said data collection and reporting set to begin in April will inform any future changes.

Ending note

Supporters framed the bill as part of a broader effort to lower health-care costs and prevent loss of providers; opponents warned it could limit recovery for seriously injured patients. Lawmakers adopted a targeted amendment intended to protect plaintiffs' access to life-care awards while imposing an insurance threshold for providers seeking personal-asset protection.