PRINTER'S NO. 2795
No. 1994 Session of 2007
INTRODUCED BY GODSHALL, MICOZZIE, BENNINGHOFF, BOYD, CAPPELLI,
CLYMER, EVERETT, FAIRCHILD, GEIST, GINGRICH, HERSHEY, HESS,
KILLION, MILNE, MOUL, MOYER, PETRI, PHILLIPS, REED, REICHLEY,
RUBLEY, SONNEY, STERN, SWANGER AND TRUE, OCTOBER 30, 2007
REFERRED TO COMMITTEE ON INSURANCE, OCTOBER 30, 2007
AN ACT
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.
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 2008 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
20070H1994B2795 - 5 -
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, 2008, 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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