Two States Mired in Malpractice Crisis. (Penn., W.Va. Fear Loss of OB.GYNS.).

Although malpractice insurance rates are rising all across the country, the pain may be worst for physicians in two states: Pennsylvania and West Virginia.

Other regions of the country have serious malpractice insurance problems, but these two states are unique in how rapidly serious crisis situations have developed, said Dr. Albert Stunk, vice president for fellowship activities of the American College of Obstetricians and Gynecologists.

In 1996, Pennsylvania ranked among the cheapest one-third of states in malpractice insurance rates. Since then, the rates have risen 120%-150%, according to the state's Medical Liability Professional Catastrophe Loss (CAT) Fund. There are now obstetricians in Pennsylvania who pay in excess of $100,000 a year for coverage. Although obstetricians in other parts of the country may pay up to $150,000 a year in premiums, Pennsylvania and West Virginia are noteworthy for the rapidity with which malpractice premiums have increased, as well as other factors that have driven the situation to crisis levels.

In West Virginia, physicians fear that many may soon be without insurance. The state has only three companies that provide 80% of the coverage, and those insurers are reportedly starting to drop physicians who have any history of a malpractice payment.

Physicians in both states say they are being driven out of state or out of practice.

Dr. Richard K. Krauss of Philadelphia is one such ob.gyn. On June 25, Dr. Krauss performed the last delivery he may ever do in Pennsylvania. Last year Dr. Krauss paid $54,000 a year for his obstetric malpractice insurance. This year he was quoted a rate of $80,000.

Reimbursement, on the other hand, has not kept up. The reimbursement for delivering a baby in Philadelphia has increased only about 10% over the last 15 years-to about $1,500, he said.