TALLAHASSEE – The Florida Legislature has passed new restrictions on the right of injured patients to sue the medical professionals that treat them.

Republican lawmakers struggling to contain Florida’s $21 billion Medicaid program have said they were offering the enticement of fewer lawsuit losses for hospitals, doctors and insurers as a way to get cooperation on their plans to contain costs within Medicaid.

To that end, the House of Representatives passed legislation, 94-21, on Wednesday that would splace new restrictions on the use of “expert witnesses” in lawsuits. But the Senate removed language that would have shielded hospitals from liability for injuries caused by health-care providers they contract with.

This bill (HB479) originally said a hospital would not be liable for negligence of any contracted health care provider unless the hospital “expressly directs or exercises actual control” over the conduct that caused the injury.

The bill still places new restrictions on the use of “expert witnesses” in lawsuits, an effort the medical community has coveted for a decade.

“We have been working to pass expert witness reform for over a decade and we consider the passage of this legislation to be major step forward in making Florida a more friendly place to practice medicine,” said Florida Medical Association President Madelyn E. Butler in a statement.

Although lawsuits, insurance premiums and the amount of damages paid have all gone down since Gov. Jeb Bush drove through caps on medical-malpractice cases in 2003, GOP lawmakers say Florida still needs to scale back medical-malpractice lawsuits in order to get more doctors to stay in the state.

At the same time, Republican legislative leaders have conceded they were offering more lawsuit-limits to the medical community this session to get buy-in for the GOP plan to reform Medicaid by putting most of its 3 million patients into managed-care.

Doctors and hospitals have traditionally fought the spread of managed care in Medicaid because it squeezed their bottom lines. And reform will worsen that squeeze: Besides putting patients in health-maintenance organizations, lawmakers are also passing a budget this week that will cut hundreds of millions of dollars in rate reimbursements for Medicaid providers.

House and Senate Medicaid negotiators had also planned to slip more lawsuit limits in the final Medicaid reform package that will be unveiled Thursday in the Senate. The Senate’s original Medicaid plan (SB 1972) would limit “pain and suffering” damages in wrongful-death lawsuits against nursing homes to $250,000.

And doctors or hospitals treating Medicaid patients would have their liability capped at $300,000, unless the injured parties were able to prove that the provider acted “in bad faith or with malicious purpose.”

The House added a similar $300,000 cap to its Medicaid package (HBs 7107, 7109).

Florida’s last major overhaul of medical malpractice produced non-economic caps of $500,000 for doctors and $750,000 for hospitals.

Malpractice claims and payouts have decreased since the 2003 reforms, and the number of doctors in the state has grown.

The number of closed lawsuits has dropped from 3,574 in 2004 to 3,087 in 2009, the last year that the Office of Insurance Regulation has data. Payouts have fallen from $664 million to $570 million during the same time frame, and total premiums paid dropped to $550 million, from $860 million.

But backers argue Florida still lags the nation in recruiting and keeping doctors with specialties such as emergency medicine, neurology, orthopedics and internal medicine.

More than one-third of the state’s doctors are over the age of 56, according to the Department of Health. And doctors still pay much higher medical-malpractice premiums than their peers in other states — nearly $42,000 for primary-care doctors in 2009 and $171,000 for specialists.

But the same studies that identify the doctor shortages list the state’s large uninsured population and lack of residency-training programs as primary reasons for the lack of doctors. And a DOH survey of 23,297 active physicians last year found “low compensation” — not lawsuits — as the main reason doctors weren’t accepting new Medicaid patients. Of the 8,529 doctors not accepting new patients, 42 percent said low pay was the reason.