"What do I look like, Harry Houdini?" Michael A. Petruccelli responded with a laugh when asked his thoughts on what changes in health care would occur in 2013. No, Petruccelli may not be a magician, but he and his firm are certainly familiar with health care law and what’s going on in the medical field.

 

Petruccelli, of Fann & Petruccelli, P.A. in Fort Lauderdale, handles medical malpractice litigation for hospitals and health care providers, and physicians, nurses and other hospital personnel. "We do peer review types of matters for hospitals dealing with credentialing and physician discipline," he explained. "We’ve handled advance directives for hospitals, and sometimes hospitals ask us to petition for a guardianship when a patient doesn’t have a designated health care surrogate or a proxy and can’t make decisions for themselves."

 

With this experience, Petruccelli is definitely qualified to give his views on what might be happening with health care in 2013. He first mentioned the idea of hospitals buying more physician practices, saying, "You’re probably going to have more integrated health systems – you’ll see practice management groups bought by hospitals. And when you’ve got more physicians as part of your hospital – they’re your agents, so you’re probably going to see an increase in malpractice claims."

 

He discussed the need for businesses to be prepared to deal with what’s going to happen when the Patient Protection Affordable Care Act is fully implemented. "From our standpoint, we’re a small business, we don’t have 50 employees, but we’ve always purchased health care for our employees. Other than that, as far health care providers are concerned, we believe that there’s uncertainty regarding the health insurance exchanges, which states are going to have them and which states are not. It’s uncertain as to how all of this is going to play out, whether or not insurance will in fact be more affordable."

 

Petruccelli mentioned a particular matter currently unfolding in Florida. "We’re awaiting a ruling from the State Supreme Court as to the caps on non-economic damages that’s been pending for about nine months. There’s a case before the court as to whether the caps on non-economic damages are constitutional; so as trial lawyers for hospitals and doctors, we’ve been waiting for that decision to come down. If the court upholds it, that’s good for the doctors and hospitals because there are caps on non-economic damages – damages like pain and suffering, loss of enjoyment of life – not economic damages. Since the caps were enacted back in 2003, there’s been a dramatic reduction in the filing of malpractice cases in this state; but if the caps are declared invalid, you will see a lot more medical malpractice litigation in Florida."

 

But malpractice litigation also varies from state to state. For example, Petruccelli explained that before filing such a lawsuit in Florida, you have to conduct an investigation, and get an affidavit of an expert to say there’s reasonable grounds that medical negligence has occurred and has caused injury. You can’t just file a lawsuit claiming that a health care provider committed malpractice, you have to go through a process, serve that health care provider with what’s called a notice of intent to initiate litigation with an affidavit of an expert. That sets up a 90-day period by which you investigate the claim. When it was passed 25 or 26 years ago, the goal was to set up a system to encourage early resolution of claims and discourage frivolous claims from being filed."

 

Another area he mentioned is entitlement reform. "I think everybody agrees that eventually there’s going to have to be entitlement reform. Most health care providers take Medicare, some take Medicaid, so the government’s going to have to reduce their expenditures and reduce entitlements. Because where’s the money going to come from?"

 

Further, Petruccelli said that in talking with other people, "They concur that eventually we’re probably going to have some aspect of national tort reform in the area of medical malpractice. You may see a movement from a national perspective, because (if we’re heading toward) national health care, then the system for claims and tort claims should be uniform as well, so health care providers and insurance companies can have certainty."

 

So what do we know for sure? Very little, except that lawyers like Petruccelli will be following the action and keeping up to date as the calendar pages turn.