Since 1976, medical malpractice claims against the State of Louisiana have been governed by the Malpractice Liability for State Services Act (MLSSA), sometimes referred to as the Public Act, found at La. R.S. 40:1299.39, et seq. The MLSSA generally provides for the limitation of liability and damages for medical malpractice committed by health care providers employed or contracted by the State of Louisiana or who are working at a state hospital or who are treating a patient referred by a state hospital without compensation or reimbursement. The MLSSA does not cover political subdivisions of the state or hospital service districts established by the Legislature. 40:1299.39(A)(1)(b) and 40:1299.39(M). Malpractice is defined as the failure to exercise the reasonable standard of care, when such failure proximately causes injury to a patient.