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HEHS-95-118R 1 (1995-04-04)

handle is hein.gao/gaobackue0001 and id is 1 raw text is: (3 -O United States M )O General Accounting Office Washington, D.C. 20548 Health, Education and Human Services Division B-260844 April 4, 1995 The Honorable William S. Cohen United States Senate Dear Senator Cohen: In 1990, Maine enacted a law establishing a demonstration project in which physician practice guidelines would be established and compliance with these guidelines would represent a rebuttable presumption in malpractice suits that a physician had met the standards of care for the patient. It was hoped that this project would reduce the practice of defensive medicine--ordering unnecessary diagnostic tests and performing excessive procedures to establish a defense against malpractice claims. It was also hoped that reducing defensive medicine would lower health care costs by eliminating payments for the unnecessary tests and procedures. In 1992, you and Senator George Mitchell asked us to examine the Maine Medical Liability Demonstration Project to describe its history, the factors essential to the project's establishment, and the focus of the physician practice guidelines. In October 1993, we responded by issuing a report entitled, Medical Malpractice: Maine's Use of Practice Guidelines to Reduce Costs (GAO/HRD-94-8), which explains how and why the guidelines were developed and provides a description of the guidelines' focus on physician behavior in four high-risk specialties. You also asked us to determine if there is any empirical evidence demonstrating the degree to which the use of practice parameters has reduced the number of procedures being performed by participating physicians. The unavailability of reliable data from Maine Blue Cross and Blue Shield (BC/BS) prior to implementation of the practice guidelines has prevented us from establishing a trend line to reliably assess the effect of the guidelines. On December 21, 1994, we met with your staff and discussed the numerous data-related problems encountered in trying to determine whether the practice parameters have had an effect on defensive medicine in Maine. In addition, we informed your staff that even if data were available, other GAO/HEHS-95-118R Maine Practice Guidelines

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