The Washington state Senate on Wednesday unanimously approved the changes to the state's medical malpractice system announced by Gov. Chris Gregoire (D) on Monday, the Olympian reports. The House has not yet approved the bill. According to the Olympian, the package includes changes that would prevent apologies to patients from health care providers from being used in court, as well as a requirement that lawyers would have to file certificates of merit when filing suit against health care professionals. In addition, the bill would place a $1 million cap on noneconomic damage awards in malpractice cases that go to arbitration instead of trial. The malpractice bill also would enable the insurance commissioner to reject increases in doctors' insurance premiums and collect data on malpractice payouts for analysis, the Olympian reports. The plan would give immunity to people who report health care providers for unprofessional conduct and require hospitals to report major patient injuries to the state. Under the bill, members of the public would be added to the doctor disciplinary board (Wilson, Olympian, 2/23). According to the AP/Spokane Spokesman-Review, the compromise plan was "hammered out by ... Gregoire in weeks of secret negotiations." Some Republican senators tried to add measures "preferred by the health care industry," such as limits on attorney fees or caps on lawsuit damages, but Democrats resisted the efforts, the AP/Spokesman-Review reports. State Sen. Alex Deccio (R) said, "This is a work in progress, and I think we need to understand there are many, many issues that are not dealt with." State Senate Health and Long Term Care Committee Chair Karen Keiser (D) agreed more needs to be done, adding, "This isn't the end-all and be-all of patient safety. But it's not all we're going to do" (Woodward, AP/Spokane Spokesman-Review, 2/22). State Sen. Brian Weinstein (D) said, "Patient safety should be our primary concern, but this bill in reality does very, very little for patient safety" (Olympian, 2/23).