Court said backers want the initiative ready for signature-gathering this fall.

“We want to give the Legislature one more shot at this during this session before having to resort to the initiative,” he said.

Initiative backers said that they have yet to decide on whether to raise the $250,000 medical malpractice cap or eliminate it entirely.

Other provisions being considered include: adding public members to the state Medical Board, which is now mostly doctors; boosting the authority of the state attorney general to investigate physicians; mandatory drug and alcohol testing for all doctors, and creation of an online database that tracks prescriptions to screen for doctors who overprescribe certain drugs.

But it’s the Micra cap reform that’s raising the loudest alarms in the medical community. They say it would encourage plaintiffs to file meritless lawsuits against physicians.

“At the core of this supposed ballot measure is the lawyers’ attempt to change Micra to make it more lucrative for trial lawyers to file meritless lawsuits and receive higher payouts,” said Lisa Maas, executive director of Californians Allied for Patient Protection, the newly formed coalition to defend Micra. “More lawsuits may enrich trial lawyers, but it will cost California’s health care consumers billions in higher health care costs and reduced access to health care services.”

Health care providers say the biggest impact will likely come to non-profit health care clinics and hospitals, especially those serving high numbers of indigent patients.

“Before Micra, our clinic almost went out of business as a result of exorbitant malpractice insurance rates,” said Jim Mangia, chief executive of St. John’s Well Child and Family Center, which operates 12 clinics in downtown and South Los Angeles. “If this passes and we have to pay several hundred thousand dollars more in malpractice insurance or to defend against lawsuits, then we can’t use that money for our patients. We would have to treat fewer people, which could mean having to shut down some of our clinics.”