California Proposition 46, the Medical Malpractice Lawsuits Cap and Drug Testing of Doctors Initiative, is on the November 4^th ballot, and could impact malpractice liability awards if passed. The initiative was introduced earlier this year by Consumer Watchdog, a group based in Santa Monica.

The main points of the initiative include:

• Increasing the state's cap on the non-economic damages that can be assessed in medical negligence lawsuits from $250,000 to $1.1 million.
• Requiring all health care practitioners to consult a state prescription drug history database before prescribing certain controlled substances. This could help prevent patients from "doctor shopping" for multiple prescriptions of controlled substances.
• Requiring drug and alcohol testing of doctors. Those with positive tests would be reported to the California Medical Board. This would be the first law in the U.S. to require random drug testing of physicians.
• Requiring the Board to suspend doctors with a positive test pending an investigation, and taking disciplinary action against doctors found impaired while on duty.
• Requiring health care practitioners to report any physician suspected of medical negligence or being impaired by drugs or alcohol.

The Medical Injury Compensation Reform Act (MICRA) was instituted in 1975 by then Governor Jerry Brown in response to requests from the medical community to manage rising medical malpractice judgments. There are no limits on economic impacts such as lost wages or medical bills.

"The cap on non-economic damages was instituted in 1975 and has not been changed for 39 years with no provision for increase due to inflation," explains Barry Zalma of Zalma Insurance Consultants. "Proposition 46 raises the maximum to $1.1 million. Because of the limitation very few attorneys will handle medical malpractice cases and the contingency fees are very limited compared to what they can earn on other tort cases."