HHS Secretary Michael Leavitt

Forced by a mandate in the 2003 Medicare law, the Bush administration has proposed caps for noneconomic damages in medical malpractice lawsuits and a mandate for providers to use electronic health records.

The proposal was expected to be introduced in bill form within days, despite negative reactions to it by Democrats, who control both chambers of Congress. The legislative proposal also would increase Medicare drug benefit premium costs for higher-earning beneficiaries.

The administration had to submit the proposals because Medicare trustees had estimated for a second straight year that the program would eclipse a 45% spending threshold within seven years. Department of Health and Human Services Secretary Michael Leavitt formally made the proposal in a letter to House Speaker Nancy Pelosi (D-CA) on Friday.

The tort reform provision would shorten the time frame in which malpractice suits could be filed. It also would limit noneconomic damages to $250,000 per case.

A nationwide, interconnected electronic health records system would require that records be made available to Medicare beneficiaries. Cost and quality data about providers would also have to be provided, and beneficiaries would be rewarded for using more efficient providers.