In 2012, the Missouri Supreme Court struck down that state's med mal damage cap. The legislature has passed a replacement, and it is now awaiting Governor Jay Nixon's decision whether to sign it. In sum: The bill, if signed into law, would place a $400,000 cap on noneconomic damage awards in medical malpractice cases. The cap would be raised to $700,000 for catastrophic and wrongful death cases. Both caps would then increase by 1.7 percent each year.
There is a catch to the law. A jury would still be able to award an amount greater than the allowed caps. If a motion is then made contesting the award, the trial court will determine whether the limitations apply in that case.The reason I say this sounds like an "optional" cap is that the jury apparently will not be told of the cap and it will only be applied if the affected party requests it AND the court decides to apply it. I assume that a decision not to apply it will be reviewable (and I also assume under an abuse of discretion standard, but I don't know).
UPDATE 5/12/15: The bill has been signed into law. Details here.