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Iowa Malpractice Cap Approved Under House File 161

on Thursday, 23 February 2023 in Health Law Alert: Erin E. Busch, Editor

In Iowa, House File 161 was enacted and went into effect February 16, 2023, revising   Iowa Code § 147.136A.  The new law establishes a cap on noneconomic damage awards against health care providers and hospitals.  This tort reform comes at a welcomed time with many community-level hospitals across the state of Iowa closing birthing units and other service lines due to the rising cost of insurance premiums and the inability to find providers willing to staff the units.   

Iowa Code § 147.136A(1) defines noneconomic damages and now clarifies that the loss of dependent care is not an noneconomic expense.  

  • “Noneconomic damages” means “‘damages arising from pain, suffering, inconvenience, physical impairment, mental anguish, emotional pain and suffering, loss of chance, loss of consortium, or any other nonpecuniary damages.”
  • “Noneconomic damages” does not include “the loss of dependent care, including the loss of child care, due to the death of or severe injury to a spouse or parent who is the primary caregiver of a child under the age of eighteen or a disabled adult.” The loss of dependent care is expressly an economic damage.

Iowa Code § 147.136A(2) was also amended placing a $250,000 cap on noneconomic damages for personal injury or death against a health care provider for any occurrence resulting in injury or death of a patient unless a jury determines that (i) there is substantial or permanent loss or impairment of a bodily function, (ii) substantial disfigurement, (iii) loss of pregnancy, or (iv) death, and that the aforementioned cap would deprive the plaintiff of “just compensation” for the injuries.  In such a case, the maximum amount recoverable shall not exceed $1,000,000 against a health care provider or $2,000,000 if the civil action includes a hospital, as defined under Iowa Code § 135B.1. The coverage caps will increase by 2.1% on January 1, 2028, and each January 1 thereafter, with the amount recoverable based on the cap in place on the date of the occurrence.

Iowa’s malpractice cap remains distinguishable from Nebraska’s in that it only limits noneconomic damages, whereas Nebraska provides a total cap on damages (economic and noneconomic damages). Nevertheless, the cap on noneconomic damages could be helpful in light of closures of service lines at community-based hospitals across Iowa, particularly the closure of birthing units.  Many of the closures are due in part to a lack of providers who are willing to provide OB and delivery services in face of the malpractice risk.  The newly revised law may encourage more providers to provide OB services in Iowa.

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