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California’s Long-Standing MICRA Law is About to Change

California’s controversial Medical Injury Compensation Reform Act of 1975 (MICRA) could soon change following the efforts of health care and consumer advocates, who worked with California legislative leaders to reach an agreement to modernize the law, resulting in the introduction of Assembly Bill 35 (AB 35) on April 27, 2022. Along with changes to the contingency fee arrangements for plaintiffs’ attorneys, the most significant change in the bill will be an increase in the current cap on non-economic damages, which has been set at $250,000 since MICRA’s enactment. Provisions affecting health care institutions and additional evidentiary protections have also been included in the bill.

Key Changes to the Law

If AB 35 is signed into law, the following notable changes will affect cases filed or arbitrations demanded on or after January 1, 2023:

  • For non-death cases, the cap on non-economic damages will increase to $350,000, with incremental increases over the next 10 years to $750,000. For cases involving a death, the cap on non-economic damages will increase to $500,000, with incremental increases over the next 10 years to $1 million. After ten years, the limitations on non-economic damages will be adjusted annually for inflation by 2%. 

  • Three separate categories for non-economic damages caps will be created, for a total of three possible caps in each case, regardless of the number of health care providers or health care institutions, or the number of separate causes of action. Health care providers or health care institutions will each only be held liable in one category.

  • The law will add a new chapter to the Health and Safety Code establishing additional discovery and evidentiary protections for expressions of sympathy, regret, or benevolence, including statements of fault, made prior to the filing of a lawsuit or demand for arbitration.

  • Adjustments will be made to attorney contingency fee limits as follows:

    • 25% of the amounts recovered, if the recovery is due to a settlement agreement and release of claims executed by all parties prior to the filing of a civil complaint or arbitration demand.

    • 33% of the amount recovered, if the recovery is pursuant to a settlement agreement, arbitration, or judgment after the filing of a civil complaint or arbitration demand.

    • If a case has been tried or arbitrated, plaintiffs’ attorneys will be permitted to seek a higher contingency fee by filing a motion with the court and establishing good cause.

  • The minimum amount of judgment required to request periodic payments will increase from $50,000 to $250,000.

AB 35 Anticipated to Pass

MICRA has been the subject of costly disputes through ballot measures, the courts, and in the legislature over the past four decades. This year was proving to be no exception with a ballot initiative called the “Fairness for Injured Patients Act” (FIPA), which would have effectively eliminated caps on non-economic damages. FIPA will be withdrawn from the November ballot if Governor Newsom signs AB 35 into law by June 30, 2022.

With the support of the legislators from both houses, Californians Allied for Patient Protection, Consumer Attorneys of California, and patient and health care advocate groups, AB 35 seems very likely to pass. Health care institutions, health care professionals, and insurers should review existing policies and procedures, and consult with legal counsel to determine what measures should be taken to align with MICRA’s new framework.

© Polsinelli PC, Polsinelli LLP in CaliforniaNational Law Review, Volume XII, Number 125

About this Author

Rebecca Hoyes Healthcare Attorney Polsinelli San Francisco

Rebecca Hoyes has an extensive background in the healthcare sector on various legal issues, including the representation of hospitals and their medical staffs in peer review investigations, corrective action, hearings and appeals. She counsels clients on privileging and credentialing of AHPs and physicians; bylaws, rules and policies; compliance with accreditation, licensure and regulatory requirements; practitioner disruptive behavior, disability and impairment; responding to subpoenas by state agencies requesting peer review or health information; and medical staff...


Tish Pickett is an associate in the Health Care Litigation and Disputes practice group. She is committed to providing practical legal advice in the constantly evolving health care industry. Tish’s practice focuses on providing strategic counsel on issues related to the Federal Anti-Kickback Statute and the False Claims Act, state fraud and abuse laws, and HIPAA and state privacy laws.

Prior to joining Polsinelli, Tish served as in-house counsel for a health care technology company in which she provided advice on such matters as consumer protection and patient privacy laws impacting...