Associated Press WriterJEFFERSON CITY, Mo. (AP) -- After breaking a contentious 16-hour debate, senators on Thursday passed legislation supporters say will help lower doctors' malpractice insurance premiums.

The legislation would create new limits on jury awards in many types of lawsuits -- which insurance companies claim is the cause for doctors' fast-rising premiums.

After Democrats had blocked the bill from coming to a vote, a compromise was reached with Republicans that also would create a tax credit for doctors whose premiums are on the rise and give state regulators more power to restrict rates charged by insurance companies.

Last year, the Republican-led Legislature approved a similar bill to limit lawsuits, but it was vetoed by Gov. Bob Holden, a Democrat. Holden has said he wants to sign a bill that is tailored to address just medical malpractice.

A new lawsuit-limit bill was approved last month by the House. After amending that bill, the Senate agreed to its format late Wednesday night, then returned Thursday to pass it on a 24-8 vote.

If the House does not accept all of the Senate changes, the legislation next would go to a conference committee, where negotiators would try to work out a final version.

Republicans said they were not happy with the tax credit or insurance regulations that were added to the bill and that they may be removed from the final version. Meanwhile, Democrats said they did not like provisions limiting where lawsuits can be filed and when defendants can be held liable for judgments.

Senate President Pro Tem Peter Kinder said the bill still includes many provisions that will help lower doctors' premiums.

"It is good strong tort reform, general business tort reform -- especially medical malpractice reform," said Kinder, R-Cape Girardeau.

Senate Minority Leader Ken Jacob said even with the changes, he would advise Holden to veto the bill.

"The provisions regarding tort are unconscionable, and I would advise the governor -- and expect the governor -- to veto the bill," said Jacob, D-Columbia. The bill "really tips the scales of justice in favor of the person who committed the tort as opposed to the victim."

A tort is a type of lawsuit that includes medical malpractice, personal injury, wrongful death, libel, slander and other acts.

The bill approved by the Senate would create new limits on tort lawsuits, including caps on jury awards, the location where a case is tried and the requirement of one defendant to pay for co-defendants' damages.

One of the more controversial issues has been the cap on payments for pain and suffering, or noneconomic damages. The existing cap of $565,000, which changes annually with inflation, would be lowered to $450,000 and would stay the same until 2006, when the yearly inflation adjustment would resume.

The bill would also create a new $200,000 cap on damages for pain and suffering in cases of medical malpractice in an emergency room. That figure would rise with inflation beginning in 2006.

Lawsuits would have to be tried in the judicial circuit where the injury occurred. For injuries that occurred out of state, the case would be tried in the judicial circuit where the plaintiff or defendant resides.

Jacob, an attorney who voted against the bill, said the venue restriction "triggers my gag reflex." He complained that the legislation makes "radical change" to tort practices that have existed for centuries.

Senators agreed to offer a tax credit -- a direct deduction on state taxes -- of 15 percent of the increase in a doctor's annual malpractice premium. Each doctor would be capped at a $15,000 credit per year, and the state could award up to $15 million in the credits per year.

The Senate-approved bill would also create new regulatory power for the Department of Insurance. Insurers would be limited to raising rates by 20 percent more than the previous year's market median. The House had previously approved the insurance regulation wording in a separate bill.

------Lawsuit limit bill is HB1304.

On the Net:

Missouri Legislature: http://www.moga.state.mo.us