The jury is still in: Florida's birth-related neurological injury compensation plan after a decade

Florida's Birth-Related Neurological Injury Compensation Plan (NICA) is the most significant experiment with compensation for medical injury yet under taken in the United States. As NICA enters its second decade of operation, maintaining the scheme's jurisdictional integrity has emerged as a key chal lenge for policy makers in Florida. We explore the relationship that has em erged between NICA and the tort system as competing avenues for families to obtain compensation for severe birth-related neurological injury. By linki ng NICA claims data with data on malpractice claims filed in Florida, we fo und a lively persistence of "bad baby" litigation despite NICA's implementa tion. Many families pursued claims in both fora. An explanation for these r esults can be traced to key features of the plan's design-primarily, the wa y in which "exclusive" jurisdiction over injuries is determined and the res trictive nature of the compensation criteria used. Our findings may help ef forts to consolidate NICA's role in injury compensation and inform future d esign of alternative compensation systems.