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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| HOUSE BILL |
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| INTRODUCED BY GODSHALL, BAKER, BEYER, BOYD, CARROLL, CLYMER, FLECK, GEIST, GROVE, MILNE, MOUL, PAYNE, PETRI, PYLE, ROAE, SIPTROTH, STERN, SWANGER, TRUE AND WATSON, FEBRUARY 2, 2009 |
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| REFERRED TO COMMITTEE ON INSURANCE, FEBRUARY 2, 2009 |
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| AN ACT |
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1 | Amending the act of March 20, 2002 (P.L.154, No.13), entitled |
2 | "An act reforming the law on medical professional liability; |
3 | providing for patient safety and reporting; establishing the |
4 | Patient Safety Authority and the Patient Safety Trust Fund; |
5 | abrogating regulations; providing for medical professional |
6 | liability informed consent, damages, expert qualifications, |
7 | limitations of actions and medical records; establishing the |
8 | Interbranch Commission on Venue; providing for medical |
9 | professional liability insurance; establishing the Medical |
10 | Care Availability and Reduction of Error Fund; providing for |
11 | medical professional liability claims; establishing the Joint |
12 | Underwriting Association; regulating medical professional |
13 | liability insurance; providing for medical licensure |
14 | regulation; providing for administration; imposing penalties; |
15 | and making repeals," further providing for medical |
16 | professional liability insurance, for basic coverage limits, |
17 | for Medical Care Availability and Reduction of Error Fund |
18 | liability limits and for extended claims. |
19 | The General Assembly of the Commonwealth of Pennsylvania |
20 | hereby enacts as follows: |
21 | Section 1. Sections 711(d), 712(c) and 715 of the act of |
22 | March 20, 2002 (P.L.154, No.13), known as the Medical Care |
23 | Availability and Reduction of Error (Mcare) Act, are amended to |
24 | read: |
25 | Section 711. Medical professional liability insurance. |
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1 | * * * |
2 | (d) Basic coverage limits.--A health care provider shall |
3 | insure or self-insure medical professional liability in |
4 | accordance with the following: |
5 | (1) For policies issued or renewed in the calendar year |
6 | 2002, the basic insurance coverage shall be: |
7 | (i) $500,000 per occurrence or claim and $1,500,000 |
8 | per annual aggregate for a health care provider who |
9 | conducts more than 50% of its health care business or |
10 | practice within this Commonwealth and that is not a |
11 | hospital. |
12 | (ii) $500,000 per occurrence or claim and $1,500,000 |
13 | per annual aggregate for a health care provider who |
14 | conducts 50% or less of its health care business or |
15 | practice within this Commonwealth. |
16 | (iii) $500,000 per occurrence or claim and |
17 | $2,500,000 per annual aggregate for a hospital. |
18 | (2) For policies issued or renewed in the calendar years |
19 | 2003, 2004 and 2005, the basic insurance coverage shall be: |
20 | (i) $500,000 per occurrence or claim and $1,500,000 |
21 | per annual aggregate for a participating health care |
22 | provider that is not a hospital. |
23 | (ii) $1,000,000 per occurrence or claim and |
24 | $3,000,000 per annual aggregate for a nonparticipating |
25 | health care provider. |
26 | (iii) $500,000 per occurrence or claim and |
27 | $2,500,000 per annual aggregate for a hospital. |
28 | (3) Unless the commissioner finds pursuant to section |
29 | 745(a) that additional basic insurance coverage capacity is |
30 | not available, for policies issued or renewed in calendar |
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1 | year 2006 and each year thereafter subject to paragraph (4), |
2 | the basic insurance coverage shall be: |
3 | (i) $750,000 per occurrence or claim and $2,250,000 |
4 | per annual aggregate for a participating health care |
5 | provider that is not a hospital. |
6 | (ii) $1,000,000 per occurrence or claim and |
7 | $3,000,000 per annual aggregate for a nonparticipating |
8 | health care provider. |
9 | (iii) $750,000 per occurrence or claim and |
10 | $3,750,000 per annual aggregate for a hospital. |
11 | If the commissioner finds pursuant to section 745(a) that |
12 | additional basic insurance coverage capacity is not |
13 | available, the basic insurance coverage requirements shall |
14 | remain at the level required by paragraph (2); and the |
15 | commissioner shall conduct a study every two years until the |
16 | commissioner finds that additional basic insurance coverage |
17 | capacity is available, at which time the commissioner shall |
18 | increase the required basic insurance coverage in accordance |
19 | with this paragraph. |
20 | (4) Unless the commissioner finds pursuant to section |
21 | 745(b) that additional basic insurance coverage capacity is |
22 | not available, for policies issued or renewed three years |
23 | after the increase in coverage limits required by paragraph |
24 | (3) and for each year thereafter, the basic insurance |
25 | coverage shall be: |
26 | (i) [$1,000,000] $500,000 per occurrence or claim |
27 | and [$3,000,000] $1,500,000 per annual aggregate for a |
28 | participating health care provider that is not a |
29 | hospital. |
30 | (ii) [$1,000,000] $500,000 per occurrence or claim |
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1 | and [$3,000,000] $1,500,000 per annual aggregate for a |
2 | nonparticipating health care provider. |
3 | (iii) $1,000,000 per occurrence or claim and |
4 | $4,500,000 per annual aggregate for a hospital. |
5 | [If the commissioner finds pursuant to section 745(b) that |
6 | additional basic insurance coverage capacity is not |
7 | available, the basic insurance coverage requirements shall |
8 | remain at the level required by paragraph (3); and the |
9 | commissioner shall conduct a study every two years until the |
10 | commissioner finds that additional basic insurance coverage |
11 | capacity is available, at which time the commissioner shall |
12 | increase the required basic insurance coverage in accordance |
13 | with this paragraph.] |
14 | * * * |
15 | Section 712. Medical Care Availability and Reduction of Error |
16 | Fund. |
17 | * * * |
18 | (c) Fund liability limits.-- |
19 | (1) For calendar year 2002, the limit of liability of |
20 | the fund created in section 701(d) of the former Health Care |
21 | Services Malpractice Act for each health care provider that |
22 | conducts more than 50% of its health care business or |
23 | practice within this Commonwealth and for each hospital shall |
24 | be $700,000 for each occurrence and $2,100,000 per annual |
25 | aggregate. |
26 | (2) The limit of liability of the fund for each |
27 | participating health care provider shall be as follows: |
28 | (i) For calendar year 2003 and each year thereafter, |
29 | the limit of liability of the fund shall be $500,000 for |
30 | each occurrence and $1,500,000 per annual aggregate. |
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1 | (ii) If the basic insurance coverage requirement is |
2 | increased in accordance with section 711(d)(3) and, |
3 | notwithstanding subparagraph (i), for each calendar year |
4 | following the increase in the basic insurance coverage |
5 | requirement, the limit of liability of the fund shall be |
6 | $250,000 for each occurrence and $750,000 per annual |
7 | aggregate. |
8 | [(iii) If the basic insurance coverage requirement |
9 | is increased in accordance with section 711(d)(4) and, |
10 | notwithstanding subparagraphs (i) and (ii), for each |
11 | calendar year following the increase in the basic |
12 | insurance coverage requirement, the limit of liability of |
13 | the fund shall be zero.] |
14 | (3) For calendar year 2009 and each year thereafter the |
15 | limit of liability of the fund shall be zero. |
16 | * * * |
17 | Section 715. Extended claims. |
18 | (a) General rule.--If a medical professional liability claim |
19 | against a health care provider who was required to participate |
20 | in the Medical Professional Liability Catastrophe Loss Fund |
21 | under section 701(d) of the act of October 15, 1975 (P.L.390, |
22 | No.111), known as the Health Care Services Malpractice Act, is |
23 | made more than four years after the breach of contract or tort |
24 | occurred and if the claim is filed within the applicable statute |
25 | of limitations, the claim shall be defended by the department if |
26 | the department received a written request for indemnity and |
27 | defense within 180 days of the date on which notice of the claim |
28 | is first given to the participating health care provider or its |
29 | insurer. Where multiple treatments or consultations took place |
30 | less than four years before the date on which the health care |
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1 | provider or its insurer received notice of the claim, the claim |
2 | shall be deemed for purposes of this section to have occurred |
3 | less than four years prior to the date of notice and shall be |
4 | defended by the insurer in accordance with this chapter. |
5 | (b) Payment.--If a health care provider is found liable for |
6 | a claim defended by the department in accordance with subsection |
7 | (a), the claim shall be paid by the fund. The limit of liability |
8 | of the fund for a claim defended by the department under |
9 | subsection (a) shall be $1,000,000 per occurrence[.], except as |
10 | provided for in subsection (b.1). |
11 | (b.1) Limit of liability.--The limit of liability of the |
12 | fund for an occurrence or claim that arose on or after January |
13 | 1, 2009, shall be zero. |
14 | (c) Concealment.--If a claim is defended by the department |
15 | under subsection (a) or paid under subsection (b) and the claim |
16 | is made after four years because of the willful concealment by |
17 | the health care provider or its insurer, the fund shall have the |
18 | right to full indemnity, including the department's defense |
19 | costs, from the health care provider or its insurer. |
20 | (d) Extended coverage required.--Notwithstanding subsections |
21 | (a), (b) and (c), all medical professional liability insurance |
22 | policies issued on or after January 1, 2006, shall provide |
23 | indemnity and defense for claims asserted against a health care |
24 | provider for a breach of contract or tort which occurs four or |
25 | more years after the breach of contract or tort occurred and |
26 | after December 31, 2005. |
27 | Section 2. This act shall take effect in 60 days. |
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