MORE EVIDENCE THAT THE CONNECTICUT MEDICAL SOCIETY AND THE FAIRFIELD COUNTY MEDICAL SOCIETY CAN'T DO THE JOB

Physicians throughout Connecticut continue to complain about their medical malpractice premiums being too high and find it easy to blame lawyers and their injured patients who bring claims for wrongdoing by healthcare providers for driving up their premiums. This is the equivalent of telling a critically sick patient to "take two aspirins and call me in the morning." These very bright people should apply their collective intelligence and diagnose the real problem. If they did that, they would find the problem is GREEDY INSURANCE COMPANIES. No surprise.

What is surprising however, is that wealthy doctors are willing to fund the Connecticut State Medical Society and the Fairfield County Medical Society, paying the salaries of staff and huge sums to lobbyists who are always asleep at the switch. Last year, when one insurance company sought a rate increase against the doctors, there wasn't a peep from the medical profession. Instead, the Connecticut Trial Lawyers Association commissioned an actuarial study that demonstrated that the rate increase was unjustified and the Insurance Commissioner, after considering all of the evidence, denied the increase. Effectively, consumers and the doctors were represented by the Trial Lawyers Association.

Now again, CMIC, the physician owned and controlled insurance company, has been exposed for gouging its own members. A recent report from the same actuary that documented last year's data before the Insurance Commissioner has now documented that CMIC has been enjoying excessive profits; a high level of surplus growth; a surplus that is disproportionately high in relation to the premiums charged; and has engaged in a persistent pattern of reporting excessive reserves which would actually tend to reduce the stated level of profit artificially as well as to reduce taxes paid to the governement.

This matter was the subject of the following news article in The [Hartford] Courant today:

http://www.courant.com/news/health/hc-docrates1018.artoct18,0,6749243.story?coll=hc-headlines-health

Medical Insurer Under Fire

Trial Lawyers Ask For State's Help

By DIANE LEVICKCourant Staff Writer

October 18 2006

Trial lawyers are asking regulators to consider seeking a rollback of malpractice rates at Connecticut Medical Insurance Co., saying the premiums for doctors appear excessive in light of the company's profits and surplus.

Carl D. Anderson, president of the Connecticut Trial Lawyers Association, sent a letter Tuesday to Insurance Commissioner Susan F. Cogswell urging a "thorough examination" of Connecticut Medical's malpractice rates.

The Glastonbury-based insurer didn't raise rates for 2006 and isn't planning any across-the-board increase for 2007, though about 5 percent of policyholders could see some increase or decrease based on their risk classification.

ProMutual Group, which insures just over 3,000 doctors and other medical professionals in Connecticut, isn't planning a rate increase here either for 2007.

Anderson noted that the state insurance department last year rejected a rate increase by ProMutual Group. In a statement Tuesday, he said the department should take action again to "ensure that companies, like CMIC and ProMutual, do not continue to gouge doctors with unreasonably high rates - while guaranteeing ever increasing profits for their insurance company."

Debra J. Korta, a spokeswoman for Cogswell, said the department wouldn't comment Tuesday because it hadn't yet reviewed Anderson's letter or an actuary's report commissioned by the trial lawyers' association.

Allan Schwartz, the report's author and president of AIS Risk Consultants Inc. in Freehold, N.J., said that a double-digit rate reduction - maybe 10 percent or more - would be "consistent with the high level of profit [Connecticut Medical is] showing." Schwartz said he can't give an exact number based on the publicly available data from the company.

Connecticut Medical officials could not be reached for comment Tuesday. The company covered about 2,500 physicians in 2004, but an updated number could not be obtained Tuesday.

Trial lawyers have been clamoring for lower medical malpractice premiums in recent years for at least two reasons. The lawyers want to make sure the insurance remains available and affordable to physicians because it's a source of money for malpractice victims and attorneys' fees.

In addition, the lawyers object to caps on pain and suffering damages and don't want high premiums to be used to justify them. So far, Connecticut legislators have not passed such limits on damages, despite heavy lobbying by physicians and insurers.

Now trial lawyers see an opportunity to reduce premiums.

Schwartz's report, which covers 2004 through June 30 of this year, says Connecticut Medical's net income is "highly excessive" in relation to earned premiums. The company shows a "consistent pattern of over-reserving" for claims, and its surplus - the financial cushion - is "disproportionately high" in relation to premiums, the report says.

However, rating agencies look at surplus too, among other measures, and Connecticut Medical has only the fifth highest financial health rating - B++ ("very good") - from A.M. Best Co.

Connecticut Medical's annual report shows net income - bottom-line profit - of $12.5 million for 2005, up from $7.6 million in 2004. The company noted that 2005 results benefited from $3.3 million of realized capital gains on investments, and from funds set aside in previous years, but no longer needed, to pay claims.

"Doctors have the right to expect their premiums will reflect the fact that this particular carrier is doing extremely well," Anderson said.

Attorney General Richard Blumenthal echoed the call for a review of Connecticut Medical's rates after the trial lawyers sent him copies of Anderson's letter and Schwartz's report.

"The levels of profit seem astonishingly high compared with the gloom and doom reports that insurers have given the public about how unprofitable this business is," Blumenthal said. "Medical malpractice no longer seems to be the poor sibling among insurance lines."

Copyright 2006, Hartford Courant

Is your legislator one who has been duped by the insurance industry and the medical profession?

Stewart M. Casper, Esq.
Casper & de Toledo LLC
1458 Bedford St.
Stamford, CT 06905
203-325-8600

www.casperdetoledo.com

Lieberman's Distortion

AS PUBLISHED IN "THE ADVOCATE" OF STAMFORD 10/18/06
Letters To The Editor
Wednesday, October 18, 2006
To the editor:

At the U.S. Senate debate (Advocate news story, analysis, Oct. 17), Joe Lieberman made the contrived claim that his experience with bipartisanship was required and gave as examples recently enacted legislation, including port security and efforts concerning Long Island Sound.He failed to highlight his bipartisan lack of judgment on Iraq, Katrina, Social Security, subsidies for oil companies and special lobbyist-induced legislation for the pharmaceutical industry. Nor did he explain why his so-called bipartisan efforts at homeland security took five years after 9/11.

Lieberman also had the mendacity to accuse Ned Lamont of running a negative campaign and then proceeded to be the most negative participant in the debate, launching many unfounded ad hominem attacks.He also squirmed to distance himself from the very same criticism that he used to tarnish Lowell Weicker 18 years ago and claimed that his absenteeism was justified by his 2000 run for vice president and his quixotic effort to secure the presidential nomination in 2004, which yielded an embarrassingly poor showing in early primaries.But his excuses are shallow and fail to measure up to the serious implications of missing votes on Social Security, health care, education, Iraq and homeland security.

As to his belief that he had possessed the mantle of gravitas to secure the presidential nomination, he forgets he was sent to Washington, D.C., to make decisions and cast votes for the citizens of Connecticut and promised he would not miss votes as did his predecessor. He also promised to serve no more than three terms.So Mr. Lieberman, isn't your time up?

Stewart M. Casper
Casper & de Toledo LLC
1458 Bedford St.
Stamford, CT 06905

www.casperdetoledo.com

TIRED OF INSURANCE COMPANIES GOUGING - IT'S TIME FOR INSURANCE REFORM

OPEN LETTER TO PRESIDENT GEORGE W. BUSH:
MR. PRESIDENT, WE NEED TO START TALKING ABOUT INSURANCE REFORM
(as published in October 9, 2006, Michigan Lawyers Weekly)

Dear President Bush:

For years you have attacked lawyers and our civil justice system for a so called “lawsuit crisis” which you claim is causing insurance premiums to skyrocket and hurting the economy. Meanwhile, you have failed to hold the insurance industry responsible for fraudulently raising premiums and denying coverage while making windfall profits on the backs of Americans.

Your stalwart support of the insurance industry over Americans is unsupported even by facts and studies from your own administration. For instance, Justice Department statistics show that injury cases filed in U.S. District Courts fell 80% between 1985 and 2003 and Bureau of Justice Statistics show that the number of state personal injury trials has decreased 32% between 1992 and 2001. In Michigan the insurance industry itself reports a 75% decline in payouts to medical malpractice victims, and the numbers of civil lawsuits regarding wrongdoing and injury have been declining drastically for years.

So what is the real problem if not lawsuits and our civil justice system? The real problem is a runaway, unregulated insurance industry. There’s only one solution to that, Mr. President: insurance reform.

The insurance industry is the only industry (outside of major league baseball) that is unregulated. The trillion-dollar insurance industry, which has been making huge profits for years, must be held to the same standards as other businesses; namely fiscal accountability, transparency, and honesty.

Insurance reform would help working families, doctors, small business owners and our economy by lowering insurance premiums, ending insurance company fraud, and curtailing price gouging by the insurance industry.

There are numerous examples of insurance industry gouging, Mr. President. Despite Hurricane Katrina --and in the face of huge and rising premiums for all of us-- the insurance industry racked up $44.8 billion in profits last year for homeowners and auto insurance alone while raising its surplus by more than 7% to nearly $427 billion.

Even your wealthy friend Senator Trent Lott was cheated by the insurance industry after his Mississippi home was destroyed by Hurricane Katrina. Insurance reform could prevent such huge, economically devastating, and widespread fraud, Mr. President.

Mississippi Attorney General James Hood described insurers who defrauded homeowners after Katrina as “the robber barons of our time.” Mississippi was forced to sue the insurance industry because adjusters tried to cheat homeowners out of millions of dollars in claims. But one state, standing alone, is no match for an industry with hundreds of billions of dollars to protect it.

Here in Michigan, the insurance industry used its muscle to evade and finally destroy a law that merely required the number of medical malpractice insurance cases be reported so that lawmakers might have some idea if these lawsuits were really increasing as the insurance industry claimed (suits were rapidly declining instead).


In Oklahoma, tornado victims were cheated when State Farm acted “recklessly” and with “malice” in denying insurance claims on their family homes. The FBI raided Hospital Corporation of America offices after massive systematic Medicare insurance fraud and HCA pled guilty to 14 criminal counts and agreed to pay $1.7 million to settle the case. California earthquake victims were routinely defrauded by State Farm, and State Farm officials lied in court about it. Prudential agreed to pay a $35 million fine and set aside money to settle policyholder suits after an investigation found the company had defrauded more than 10 million life insurance customers.

In New York, Attorney General Eliot Spitzer uncovered ubiquitous wrongdoing in the insurance industry, testifying that “a small group of brokers and insurance companies essentially control the market, having created a network of interlocking connections and secret payments which ensure that the bulk of business goes to certain insurers and that profits remain high. The bottom line is the consumer pays more for coverage.”

Mr. President, we can all work together to stop this. Insurance reform worked in California. After pro-insurance “caps” on the rights of victims hobbled the legal system, insurance premiums for doctors still increased by an astounding 190%. When insurance reform was enacted, removing the insurance companies’ anti-trust exemptions, doctor’s insurance premiums finally leveled off.

In Missouri lawmakers voted overwhelmingly to give the state insurance director more authority to veto doctor’s insurance premiums that are “excessive” or otherwise inappropriate.

Insurance reform –such as legislation to remove the antitrust exemption for the insurance industry and to create accountability over hundreds of billions of dollars of our premiums dollars-- would go a long way toward helping to lower rates for everyone, and reign in insurance company fraud and price gouging.

Instead of bashing our civil court system and undermining our Constitution Mr. President, you need to stand up to the insurance industry and enact insurance reform.



Yours truly,
Jesse M. Reiter
President, Michigan Trial Lawyers Association

VOTING AND RELIGION

From the "Hartford Courant" October 8, 2006


"There should be no ambivalence voting for Lamont"

As a Jew, it is disappointing that many of my fellow Jews consider religion or a perceived but unfounded bias in favor of Israel, as a dispositive factor in casting their vote for U.S. Senator. I would hope that the priorities of Connecticut citizens and the best interests of the country would be paramount. After all, blind allegiance to faith and ethnicity seems to have caused most of the world's conflicts.

On Aug. 28, 1963, Martin Luther King, Jr. gave his "I Have A Dream" speech at the Lincoln Memorial in Washington, D.C. To this day, it remains an iconic speech. One of many memorable passages intones: "I have a dream that my four children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character." To be sure, Dr. King was pleading the case of racial equality. Yet there should be little doubt that if alive today he would similarly plead the same case of judging a person by the content of his character, his deeds and his beliefs rather than the color of his skin, his religion or his national origin.

Are we not measured by our deeds and beliefs? And if that is so, isn't it necessary to examine the morality of our political acts when we choose to vote for a candidate because of his ethnicity or his religion rather than the content of his deeds and a pattern of poor judgment?

Those who would support Mr. Lieberman simply because he is Jewish are acting in a way that is antithetical to the core beliefs of this country. Such a vote ignores the wisdom and courage that Ned Lamont has demonstrated leading us in a new direction rather than "staying the course." To those of us who know Ned, we are confident that his voice will resonate with judgment, reason and fairness without any threat to the welfare of Israel.

Stewart M. Casper, Wilton

MEDICAL RECORD ACCESS IN CONNECTICUT

This post consists of a reproduction of a memorandum from Connecticut's Office of Legislative Research summarizing Connecticut law on access to medical records. This information is quite useful:

Patient Access to Medical Records
John Kasprak, Senior Attorney

This report identifies and explains state law on patient access to medical records in a question and answer format. Throughout the report, the terms “medical records” and “health records” are used interchangeably reflecting their usage in statute. In some cases, the term “hospital records” is also used.

PATIENT ACCESS TO MEDICAL RECORDS FROM INDIVIDUAL HEALTH CARE PROVIDERS

Do Patients Have Access to Their Medical Records?
Yes. The law requires a health care provider, except in limited circumstances, to supply a patient, upon request, complete and current information the provider has about the patient's diagnosis, treatment, and prognosis. The provider must also notify a patient of any test results in his possession or requested by the provider for purposes of diagnosis, treatment, or prognosis. (CGS § 20-7c(b)).
A patient may obtain copies of his or her medical records by asking the provider in writing. The patient's attorney or authorized representative can also make such a request from a health care provider. Such records include bills, x-rays, copies of lab report results, prescriptions, contact lens specifications under certain conditions, and other technical information used to assess the patient's health condition. (CGS § 20-7c(c)).
The provider must supply the health record within 30 days of the request. (CGS § 20-7c(c)).
When Can a Provider Withhold This Information?
By law, a provider can withhold medical information from a patient if he reasonably determines that the information would be detrimental to the patient's physical or mental health or would likely cause the patient to harm himself or someone else. In such a case, the provider can supply the information to an appropriate third party or another provider who can release it to the patient. (CGS § 20-7c(d)).

Is There a Cost to Obtain Medical Records?
A provider can charge up to 45 cents per page, including any research fees, handling fees or related costs, and the cost of first class postage, if applicable, to furnish the patient's health record. Also, the provider can charge a patient the amount necessary to cover the costs of materials for providing a copy of an x-ray. (CGS § 20-7c(c)).
A provider cannot charge for supplying a health record if the person documents that it is necessary to support a Social Security claim or appeal. (CGS § 20-7c(c)).
What about Information Concerning Psychiatric or Psychological Conditions?
The law specifically says that its provisions for patients' access to their records (cited above, CGS § 20-7c(a)-(d)) do not apply to “any information relative to any psychiatric or psychological problems or conditions. ” (CGS § 20-7c(e)).

Which Providers Are Covered By These Provisions?
The law applies to people licensed or certified to furnish the following health care services: medicine and surgery, chiropractic, naturopathy, podiatry, athletic training, physical therapy, occupational therapy, substance abuse counseling, radiography, midwifery, nursing, dentistry, dental hygiene, optometry, optics, respiratory care, pharmacy, psychology, marital and family therapy, clinical social work, professional counseling, veterinary medicine, massage therapy, electrology, hearing instruments, and speech pathology and audiology. (CGS § 20-7b(b); § 20-7c(a)).
Can a Patient's Medical Records Be Released to Another Provider?

If the patient asks in writing, a provider must furnish a copy of the patient's health record to another provider. This includes x-rays and copies of lab reports, prescriptions, and other technical information used in assessing the patient's condition. The written request must specify the name of the provider who is to receive the record. The patient is responsible for the reasonable costs of providing the information. (CGS § 20-7d).

PATIENT ACCESS TO RECORDS FROM HOSPITALS AND OTHER HEALTH CARE INSTITUTIONS

Can a Person Access His Hospital Records?
Yes. By law, a health care institution (which includes a hospital and other health care facilities, see CGS § 19a-490), must provide a copy of a patient's health record upon the written request of the patient, his attorney, or authorized representative. The health record includes copies of bills, lab reports, prescriptions, and other technical information used in assessing the patient's condition. (CGS § 19a-490b(a)).
The institution must also give the patient or his designated provider a reasonable opportunity to examine retained tissue slides and retained pathology tissue blocks. When the patient, his attorney or his designated health care provider asks in writing, a health care institution must send the original retained tissue or slide or original retained tissue block directly to the institution, lab or physician the patient designates. (CGS § 19a-490b(a)).
Another statute requires each private or public hospital receiving state aid to allow a patient it treats and discharges, or his physician or attorney, to examine his hospital record, at the patient's request. The record includes the history, bedside notes, charts, pictures, and plates kept concerning the treatment. The patient, or his physician or attorney must be allowed to make copies of such information. (CGS § 4-104).

Can the Health Care Institution Charge for These Records?
An institution can charge up to 65 cents per page, including any research, clerical, and handling fees or related costs, and first class postage, if applicable. The institution can also charge the amount
necessary to cover the costs of materials for providing a copy of an x-ray or for furnishing an original retained slide, an original tissue block, or a new section cut from a retained pathology tissue block. (CGS § 19a-490b(a)).
The institution cannot charge if the health record is necessary for a documented Social Security claim or appeal. An institution must provide the requested health record within 30 days of the request, unless the patient's request was received less than 30 days from his discharge. In that case, the institution must provide the record when it is completed. (CGS § 19a-490b(b)).
An institution cannot deny a records request because of a person's inability to pay the required fees. The person must have an affidavit attesting to his inability to pay. (CGS § 19a-490b(d)).

RETENTION OF MEDICAL RECORDS—INDIVIDUAL HEALTH CARE PROVIDERS
How Long Must a Health Care Provider Keep a Patient's Medical Records?
Generally, a provider must retain a patient's medical records for seven years after the last treatment date, or three years from the patient's death. (Department of Public Health (DPH) Regs. § 19a-14-42).
Pathology slides, EEGs, and ECG tracings must also be retained for seven years, but as subsequent ECGs are taken, previous ones may be discarded if the results are unchanged. (DPH Regs. § 19a-14-42(a)).
Lab reports and PKU reports must be kept for five years and X-ray film for three years. (DPH Regs. , § 19a-14-42(b), (c)).

What Happens When a Health Care Provider Dies or Retires?
A provider who terminates a practice (or his executor or responsible relative in the case of death) must inform patients by notice published in a local newspaper and a letter sent to each patient seen within the past three years before the date the practice was discontinued. The patients' medical records must be kept for 60 days after the notice. (DPH Regs. § 19a-14-44).

What if a Patient Changes Providers?
If a patient changes providers and asks the former provider to transfer the records to the new primary care provider, the first provider need no longer retain the records. (DPH Regs. § 19a-14-43).

RETENTION OF RECORDS—HOSPITALS

How Long Must a Hospital Retain a Patient's Records?
Medical records must be filed in an accessible manner in THE HOSPITAL AND KEPT A MINIMUM OF 25 YEARS AFTER THE PATIENT'S DISCHARGE. ORIGINAL RECORDS CAN BE DESTROYED SOONER IF THEY ARE MICROFILMED BY A PROCESS APPROVED BY DPH. (DPH REGS. § 19-13-D3(D)(6)).

What Happens to the Records if a Health Care Institution Closes?
When a health care institution that ceases operations gives up its license to DPH, it must provide the department with a certified document specifying where its patient health records will be stored and the procedure for patients, former patients or their authorized representatives to access the records. (PA 05-272; CGS § 19a-490b(e)).

ELECTRONIC MEDICAL RECORDS
Must Health Care Providers and Institutions Keep Medical Records in an Electronic Format?
The law allows licensed health care institutions to create, maintain or use medical records or medical record systems in electronic format, paper, or both if the system can store medical records and patient health care information in a reproducible and secure manner. (PA 05-168; CGS § 19a-25c).
State law also allows health care providers with prescriptive authority to use electronic prescribing systems. (PA 05-168; CGS § 19a-25b).


Hope this information is helpful.

Stewart M. Casper, Esq.
Casper & de Toledo LLC
1458 Bedford St.
Stamford, CT 06905
203-325-8600
www.casperdetoledo.com

NED LAMONT - A LAWYER'S PLEA

You are being contacted on this occasion by me because you are currently represented by this firm, you have been represented in the past by this firm or you have consulted with us concerning some legal matter. In any case, Casper & de Toledo LLC and its lawyers, myself included, are grateful for the faith that you have placed in us. I hope that we have served you well.

For many years I have been critical of the performance of Connecticut's junior U.S. Senator Joseph Lieberman. My reasons have been many. In the early years, I became critical of Mr. Lieberman when he was a state legislator who cultivated the interests of insurance companies and big businesses at the expense of the interests of people. When he was attorney general of Connecticut, he resisted joining many other attorneys general around the country suing property and casualty insurance companies for engaging in illegal price fixing. His conduct was in no small measure prompted by the large campaign contributions that he received from the insurance industry.

In 1993, the Connecticut legislature voted overwhelmingly to repeal a failed automobile no-fault statute that cost consumers dearly and enriched insurance companies. Two years later, Lieberman was ignoring the elected legislative leaders of Connecticut and he was co-sponsoring federal no-fault insurance with right winger Mitch McConnell of Kentucky.

Lieberman has voted to deny asbestos victims their due in court. He has sought to restrict claims for victims of defective products. He has sought to restrict class action lawsuits. And he has often sides with insurance companies and HMOs to limit the right of victims of medical malpractice to make a fair recovery fro their injuries.

On top of all of those "law" related reasons that I felt Lieberman was not adequately representing the citizens of Connecticut we can add his stay the course defense of President Bush in Iraq; his advocacy for weakening the War on Terror by effectively running from the battle in Afghanistan; his support for federal intervention in the Terri Schiavo case; his effort to weaken public schools by supporting school vouchers; his support for right wing Judges including Justice Alito; his support of the Bush energy plan that has enriched Exxon-Mobil and other oil companies while the price of gasoline has skyrocketed; his effort to reward his pharmaceutical contributors by sponsoring legislation to extend the patent life on drugs while his wife worked as a pharmaceutical lobbyist. And I could go on.

When I heard about Ned Lamont and his effort to unseat Joe Lieberman, I was intrigued. I asked for a meeting and Mr. Lamont came to meet me at my office. I asked him all sorts of questions and he gave me candid answers. I came away convinced that not only was Ned an bright and honorable man, but also he was fully capable of representing the people of Connecticut in the U.S. Senate. And more. He would, if elected, go to Washington and represent our interests rather than those of the insurance industry, pharmaceutical companies, Halliburton, the HMOs. I found that Ned Lamont cares about the issues that are not only important to me but which are also important to most of my clients.

So having said all of that, I am now urging you to support Ned Lamont for U.S. Senate (assuming you're a registered voter in Connecticut). If you can support him with a campaign contribution that's great. But more importantly, please support him with your vote and tell your friends. Tell them he's no crazy liberal but rather a conscientious citizen who recognizes the folly of Iraq; that Iraq has made us all less safe. That Joe Lieberman and George Bush and Dick Chaney have advanced policies that are militarily inept; fiscally unsound and morally bankrupt.

Thanks for reading.

Stewart M. Casper, Esq.
Casper & de Toledo LLC