The Assembly passed legislation Monday lifting the cap on malpractice insurance damages.
That cap was installed during a special session of the 2001 Legislature after skyrocketing insurance premiums left large numbers of doctors threatening to leave Nevada.
Lawmakers acted after 60 percent of Nevada voters supported the $350,000 cap on damages for pain and suffering. But lawyers who oppose the cap saw an opening last year when it was discovered that two Las Vegas clinics had exposed thousands of patients to Hepatitis C by improper sanitation techniques.
Tick Segerblom, D-Las Vegas, himself a lawyer, urged members to support the change. He was joined by Assemblyman William Horne, D-Las Vegas, also a lawyer.
Horne said existing law protects bad doctors, "and I don't think anybody had that intention in mind when we created this legislation."
Horne also argued the law sets a very high standard for finding a physician guilty of gross negligence, requiring a jury to find "a conscious indifference to the consequences which may result from gross negligence and an indifference to the safety and welfare of a patient."
"This standard is enormous," he said.
Assemblyman Ty Cobb, R-Reno, said the law already allows full recovery for economic damages.
"The reason we put a cap on non-economic damages is to keep our doctors in Nevada," he said. "You're going to end up casting too wide a net. You're going to take in good doctors as well."
He said the result will be higher malpractice insurance rates and those costs will be passed on to patients.
Assemblyman Joe Hardy, R-Boulder City, a family doctor, said he is concerned doctors may not move to Nevada while some who are here could leave, which he said would reduce access to health care.
The final vote was 26-15 to send the legislation to the Senate. The vote was primarily along party lines with Republicans opposed to the change. They were joined by Democrats Morse Arberry and Harvey Munford. Republican Ed Goedhart voted for lifting the cap.
The existing law was the result of a crisis in 2001 when St. Paul Insurance, which covered a large percentage of Nevada doctors, announced it was pulling out of the business in Nevada.
Not only did the state pass the law capping pain and suffering damages, it created an insurance program to provide the coverage within the state.
Since then, several providers have returned and are providing coverage to Nevada doctors. Physicians say the system is working and that rates are lower as well because of the impact of the existing statutes.
Hardy said after the vote that any change in the existing law would "reset the actuarial clock." He said it has taken since the existing language was passed for insurance companies to get comfortable with lower rates and any change will cause them enough discomfort to raise premiums.