Lawmakers reopen fight over Louisiana’s 50-year-old medical malpractice cap

Louisiana's nearly 50-year-old medical malpractice law could again be up for debate in this year's legislative session.

Two proposals, Senate Bill 212 sponsored by state Sen. Greg Miller, R-Norco, and Senate Bill 366 sponsored by state Sen. Jimmy Harris, D-New Orleans, would reshape how malpractice cases are filed and how much injured patients can recover.

At the center of both bills is Louisiana's $500,000 cap on damages for mistakes made by physicians or hospitals when treating patients. The limit, which has not increased in 50 years, excludes future medical care. But it includes compensation for pain and suffering, lost wages and other damages tied to the injury or death.

Physician groups are warning that altering the system could trigger sharp increases in insurance premiums and worsen Louisiana's doctor shortage.

"I worry about the youngest and the brightest coming out of school and them not wanting to practice in a state that I love," said Dr. T. Steen Trawick Jr., president of the Louisiana State Medical Society.

Supporters of change say the cap has not kept pace with inflation and leaves severely injured patients and families with little compensation after serious events like paralysis or death.

"This is going to be a herculean body-slamming match in the Legislature," said Chip Wagar, a Louisiana medical malpractice attorney and member of the Patient Rights Advocacy Forum, a Louisiana organization that supports malpractice reform.

Louisiana's law

In 1975, lawmakers passed a package of bills to address rising medical malpractice insurance costs for doctors.

After debate between lawyers and physicians, the Legislature passed Act 817, which capped damages at $500,000 and required doctors or their insurers to pay the first $100,000 of a claim. The rest would be covered by the Patient's Compensation Fund, administered by the state and funded with a surcharge to health providers.

The law requires that before filing suit, patients must submit their case to a medical review panel made up of three health care providers — one selected by the patient, one by the accused doctor and a third chosen by those two — along with an attorney who serves as chair.

Historically, few cases have been decided in the patient's favor. The medical review panel found a breach of the standard of care, in which a provider deviated from accepted practices in a way that caused harm, in fewer than 10% of filed cases in most years, according to data from the fund. Patients can still proceed with filing their case in civil court, but the decision from the panel is entered as evidence.

The cap on damages has not been raised since the law passed and has not been adjusted for inflation. As a result, the $500,000 cap is comparable to around $3 million in 2025 dollars.

In 1992, the Louisiana Supreme Court upheld the constitutionality of the cap, and lawmakers have had little success in changing the law since it was passed.

In 2016, state Sen. Ryan Gatti authored Senate Bill 78, nicknamed "Rebecca's Law," after his daughter, who suffered a traumatic brain injury at birth and died at age 10. The bill would have raised the amount recoverable in medical malpractice claims involving severe brain injuries to a child to as much as $5 million when unanimously approved by a medical review panel or jury. The bill ultimately did not become law.

In 2017, state Rep. Steve Pugh filed House Bill 51, which would have increased the medical malpractice cap to $1 million in cases involving wrongful death. The bill failed to advance. Nor did a 2018 bill from state Sen. Rick Ward introduced Senate Bill 503, which proposed increasing the cap to $750,000 and allowing it to be adjusted over time.

What SB212 and SB366 would do

SB212 would keep the $500,000 base cap but tie it to inflation. Future medical expenses would still be excluded.

SB366 would raise the cap to $1 million, adjusted annually for inflation, and increase the amount a qualified health care provider can be directly liable for from $100,000 to $250,000.

The bill also would exclude economic damages — such as medical expenses and lost income — from the cap.

Both would allow patients to skip the medical review panel and instead rely on an affidavit from a doctor stating the standard of care was breached.

The senators who filed the bills are attorneys. Harris is a trial lawyer at Wright Gray Harris, and Miller is a self-employed attorney who focuses on property law, according to his LinkedIn profile.

Miller did not respond to interview requests. Harris declined to comment, saying he would "see what the will of the Legislature is."

Both bills have been referred to Judiciary Committee A, which is chaired by Miller. The bills will need to pass through committee before being brought before the Senate for a vote.

Doctors group sounds alarm

In a Feb. 27 Louisiana State Medical Society alert to physicians, Trawick warned that SB212 would create a "high-intensity liability environment" and could lead to "catastrophic" rate increases, particularly in specialties that are sued more often, such as obstetrics and gynecology.

Trawick, an internal medicine physician in private practice in the Shreveport area and former hospital executive, said increases could make physicians retire, send young doctors in search of work elsewhere and worsen existing shortages. He pointed to his daughter, a third-year medical student, as an example.

"How am I going to convince her to stay in Louisiana, if this is astronomical for her to just have to pay for her insurance before she even opens the doors and sees patients?" Trawick said.

The letter said OB-GYNs could see an immediate increase of up to 60% in premium costs — about an additional $30,000 per year — though an actuarial study has not yet been completed.

Trial lawyers push for change

Wagar scoffed at the idea that insurance rates would increase catastrophically.

"Arkansas, Alabama, Georgia and Florida have no caps at all," he said. "They always say, 'Oh, insurance rates will skyrocket.' Those states don't have a cap and their rates are lower than ours."

He also pointed to states without caps that have maintained well-regarded medical institutions, like Emory University in Georgia and the Mayo Clinic location in Florida.

Wagar said the cost of bringing malpractice cases — often $50,000 to $100,000 — and the cap on payout means only a dozen or so firms handle them. Under current law, the $500,000 cap includes lost wages and mental anguish and does not account for attorney fees.

"Let's say you're making $100,000 per year working offshore, and now you're disabled," Wagar said. "That $500,000 cap covers that, too. You have to take out attorney fees, expenses. It doesn't leave much."

A longstanding system

Ken Schnauder, executive director of Louisiana's Patient's Compensation Fund, said the cap is part of a system that has "worked well" for decades to handle malpractice claims.

According to the fund's most recent report to the Legislature, it has paid more than $3.4 billion in claims since its creation.

Schnauder said the $500,000 cap does not include medical costs, which are paid separately through the fund and can continue for as long as a patient needs treatment. One patient's case from 1977 is still being paid.

The compensation paid to patients has not changed much over the decades.

According to the fund's report, the average payment per claim was about $366,940 in 2001 and remained in roughly the mid-$300,000 range for most of the past two decades, though it rose to about $469,325 in 2024.