SENATE AMENDED
PRIOR PRINTER'S NOS. 545, 1992 PRINTER'S NO. 2983
No. 489 Session of 2007
INTRODUCED BY SCHRODER, RUBLEY, BARRAR, BELFANTI, CALTAGIRONE,
FRANKEL, GEORGE, GINGRICH, HENNESSEY, KAUFFMAN, KORTZ,
O'NEILL, PETRONE, PICKETT, READSHAW, REICHLEY, ROHRER, ROSS,
WATSON, DENLINGER, MURT AND LONGIETTI, FEBRUARY 26, 2007
SENATOR TOMLINSON, APPROPRIATIONS, IN SENATE, RE-REPORTED AS
AMENDED, DECEMBER 10, 2007
AN ACT
1 Amending the act of December 4, 1996 (P.L.893, No.141), entitled <--
2 "An act providing for volunteer health services; limiting
3 liability of a volunteer license holder; and requiring
4 reports,"
5 AMENDING THE ACT OF MARCH 20, 2002 (P.L.154, NO.13), ENTITLED <--
6 "AN ACT REFORMING THE LAW ON MEDICAL PROFESSIONAL LIABILITY;
7 PROVIDING FOR PATIENT SAFETY AND REPORTING; ESTABLISHING THE
8 PATIENT SAFETY AUTHORITY AND THE PATIENT SAFETY TRUST FUND;
9 ABROGATING REGULATIONS; PROVIDING FOR MEDICAL PROFESSIONAL
10 LIABILITY INFORMED CONSENT, DAMAGES, EXPERT QUALIFICATIONS,
11 LIMITATIONS OF ACTIONS AND MEDICAL RECORDS; ESTABLISHING THE
12 INTERBRANCH COMMISSION ON VENUE; PROVIDING FOR MEDICAL
13 PROFESSIONAL LIABILITY INSURANCE; ESTABLISHING THE MEDICAL
14 CARE AVAILABILITY AND REDUCTION OF ERROR FUND; PROVIDING FOR
15 MEDICAL PROFESSIONAL LIABILITY CLAIMS; ESTABLISHING THE JOINT
16 UNDERWRITING ASSOCIATION; REGULATING MEDICAL PROFESSIONAL
17 LIABILITY INSURANCE; PROVIDING FOR MEDICAL LICENSURE
18 REGULATION; PROVIDING FOR ADMINISTRATION; IMPOSING PENALTIES;
19 AND MAKING REPEALS," IN INSURANCE, FURTHER PROVIDING FOR
20 MEDICAL PROFESSIONAL LIABILITY INSURANCE, FOR THE MEDICAL
21 CARE AVAILABILITY AND REDUCTION OF ERROR FUND AND FOR
22 ACTUARIAL DATA; PROVIDING FOR THE MEDICAL CARE AVAILABILITY
23 AND REDUCTION OF ERROR (MCARE) RESERVE FUND AND THE MEDICAL
24 SAFETY AUTOMATION FUND; TRANSFERRING THE VOLUNTEER HEALTH
25 SERVICES ACT INTO THE ACT; further providing for license
26 renewal, continuing education requirements and disciplinary
27 and corrective measures; IN THE HEALTH CARE PROVIDER <--
28 RETENTION PROGRAM, FURTHER PROVIDING FOR THE ABATEMENT
29 PROGRAM, FOR THE HEALTH CARE PROVIDER RETENTION ACCOUNT AND
30 FOR EXPIRATION; FURTHER PROVIDING FOR EXPIRATION OF THE
1 PATIENT SAFETY DISCOUNT; AND MAKING A RELATED REPEAL.
2 The General Assembly of the Commonwealth of Pennsylvania
3 hereby enacts as follows:
4 Section 1. Section 6 of the act of December 4, 1996 <--
5 (P.L.893, No.141), known as the Volunteer Health Services Act,
6 is amended to read:
7 Section 6. License renewal; disciplinary and corrective
8 measures.
9 (a) Renewal term.--A volunteer license shall be subject to
10 biennial renewal.
11 (b) Fee exemption.--Holders of volunteer licenses shall be
12 exempt from renewal fees imposed by the appropriate licensing
13 board. [Volunteer]
14 (c) Continuing education.--Except as set forth in subsection
15 (d), volunteer licensees shall comply with any continuing
16 education requirements imposed by board rulemaking as a general
17 condition of biennial renewal.
18 (d) Nurses.--Volunteer licensees
19 SECTION 1. SECTIONS 711(D), 712(C) AND 745 OF THE ACT OF <--
20 MARCH 20, 2002 (P.L.154, NO.13), KNOWN AS THE MEDICAL CARE
21 AVAILABILITY AND REDUCTION OF ERROR (MCARE) ACT, ARE AMENDED TO
22 READ:
23 SECTION 711. MEDICAL PROFESSIONAL LIABILITY INSURANCE.
24 * * *
25 (D) BASIC COVERAGE LIMITS.--A HEALTH CARE PROVIDER SHALL
26 INSURE OR SELF-INSURE MEDICAL PROFESSIONAL LIABILITY IN
27 ACCORDANCE WITH THE FOLLOWING:
28 (1) FOR POLICIES ISSUED OR RENEWED IN THE CALENDAR YEAR
29 2002, THE BASIC INSURANCE COVERAGE SHALL BE:
30 (I) $500,000 PER OCCURRENCE OR CLAIM AND $1,500,000
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1 PER ANNUAL AGGREGATE FOR A HEALTH CARE PROVIDER WHO
2 CONDUCTS MORE THAN 50% OF ITS HEALTH CARE BUSINESS OR
3 PRACTICE WITHIN THIS COMMONWEALTH AND THAT IS NOT A
4 HOSPITAL.
5 (II) $500,000 PER OCCURRENCE OR CLAIM AND $1,500,000
6 PER ANNUAL AGGREGATE FOR A HEALTH CARE PROVIDER WHO
7 CONDUCTS 50% OR LESS OF ITS HEALTH CARE BUSINESS OR
8 PRACTICE WITHIN THIS COMMONWEALTH.
9 (III) $500,000 PER OCCURRENCE OR CLAIM AND
10 $2,500,000 PER ANNUAL AGGREGATE FOR A HOSPITAL.
11 (2) FOR POLICIES ISSUED OR RENEWED IN THE CALENDAR YEARS
12 2003, 2004 AND 2005, THE BASIC INSURANCE COVERAGE SHALL BE:
13 (I) $500,000 PER OCCURRENCE OR CLAIM AND $1,500,000
14 PER ANNUAL AGGREGATE FOR A PARTICIPATING HEALTH CARE
15 PROVIDER THAT IS NOT A HOSPITAL.
16 (II) $1,000,000 PER OCCURRENCE OR CLAIM AND
17 $3,000,000 PER ANNUAL AGGREGATE FOR A NONPARTICIPATING
18 HEALTH CARE PROVIDER.
19 (III) $500,000 PER OCCURRENCE OR CLAIM AND
20 $2,500,000 PER ANNUAL AGGREGATE FOR A HOSPITAL.
21 (3) UNLESS THE COMMISSIONER FINDS PURSUANT TO SECTION
22 [745(A)] 745(B) THAT ADDITIONAL BASIC INSURANCE COVERAGE
23 CAPACITY IS NOT AVAILABLE, FOR POLICIES ISSUED OR RENEWED IN
24 CALENDAR YEAR [2006] 2009 AND EACH YEAR THEREAFTER SUBJECT TO
25 PARAGRAPH (4), THE BASIC INSURANCE COVERAGE AS DETERMINED BY
26 THE COMMISSIONER SHALL BE:
27 (I) UP TO $750,000 PER OCCURRENCE OR CLAIM AND
28 $2,250,000 PER ANNUAL AGGREGATE FOR A PARTICIPATING
29 HEALTH CARE PROVIDER THAT IS NOT A HOSPITAL.
30 (II) UP TO $1,000,000 PER OCCURRENCE OR CLAIM AND
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1 $3,000,000 PER ANNUAL AGGREGATE FOR A NONPARTICIPATING
2 HEALTH CARE PROVIDER.
3 (III) UP TO $750,000 PER OCCURRENCE OR CLAIM AND
4 $3,750,000 PER ANNUAL AGGREGATE FOR A HOSPITAL.
5 IF THE COMMISSIONER FINDS PURSUANT TO SECTION [745(A)] 745(B)
6 THAT ADDITIONAL BASIC INSURANCE COVERAGE CAPACITY IS NOT
7 AVAILABLE, THE BASIC INSURANCE COVERAGE REQUIREMENTS SHALL
8 REMAIN AT THE LEVEL REQUIRED BY PARAGRAPH (2); AND THE
9 COMMISSIONER SHALL CONDUCT A STUDY EVERY [TWO YEARS] YEAR
10 UNTIL THE COMMISSIONER FINDS THAT ADDITIONAL BASIC INSURANCE
11 COVERAGE CAPACITY IS AVAILABLE, AT WHICH TIME THE
12 COMMISSIONER SHALL INCREASE THE REQUIRED BASIC INSURANCE
13 COVERAGE IN ACCORDANCE WITH THIS PARAGRAPH.
14 (4) UNLESS THE COMMISSIONER FINDS PURSUANT TO SECTION
15 745(B) THAT ADDITIONAL BASIC INSURANCE COVERAGE CAPACITY IS
16 NOT AVAILABLE, FOR POLICIES ISSUED OR RENEWED [THREE] TWO
17 YEARS AFTER THE INCREASE IN COVERAGE LIMITS REQUIRED BY
18 PARAGRAPH (3) AND FOR EACH YEAR THEREAFTER, THE BASIC
19 INSURANCE COVERAGE AS DETERMINED BY THE COMMISSIONER SHALL
20 BE:
21 (I) UP TO $1,000,000 PER OCCURRENCE OR CLAIM AND
22 $3,000,000 PER ANNUAL AGGREGATE FOR A PARTICIPATING
23 HEALTH CARE PROVIDER THAT IS NOT A HOSPITAL.
24 (II) UP TO $1,000,000 PER OCCURRENCE OR CLAIM AND
25 $3,000,000 PER ANNUAL AGGREGATE FOR A NONPARTICIPATING
26 HEALTH CARE PROVIDER.
27 (III) UP TO $1,000,000 PER OCCURRENCE OR CLAIM AND
28 $4,500,000 PER ANNUAL AGGREGATE FOR A HOSPITAL.
29 IF THE COMMISSIONER FINDS PURSUANT TO SECTION 745(B) THAT
30 ADDITIONAL BASIC INSURANCE COVERAGE CAPACITY IS NOT
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1 AVAILABLE, THE BASIC INSURANCE COVERAGE REQUIREMENTS SHALL
2 REMAIN AT THE LEVEL REQUIRED BY PARAGRAPH (3); AND THE
3 COMMISSIONER SHALL CONDUCT A STUDY EVERY [TWO YEARS] YEAR
4 UNTIL THE COMMISSIONER FINDS THAT ADDITIONAL BASIC INSURANCE
5 COVERAGE CAPACITY IS AVAILABLE, AT WHICH TIME THE
6 COMMISSIONER SHALL INCREASE THE REQUIRED BASIC INSURANCE
7 COVERAGE IN ACCORDANCE WITH THIS PARAGRAPH.
8 (5) THE AMOUNT OF BASIC INSURANCE COVERAGE PER
9 OCCURRENCE OR CLAIM UNDER PARAGRAPH (3) OR (4) SHALL BE NO
10 LESS THAN $500,000 AND SHALL BE SET IN $50,000 INCREMENTS.
11 (6) IN NO EVENT SHALL THE TOTAL COVERAGE FOR BASIC
12 PRIMARY INSURANCE AND THE FUND, PER OCCURRENCE OR CLAIM, BE
13 LESS THAN $1,000,000 OR LESS THAN $3,000,000 PER ANNUAL
14 AGGREGATE FOR A PARTICIPATING OR NONPARTICIPATING HEALTH CARE
15 PROVIDER, EXCEPT HOSPITALS WHICH HAVE TOTAL COVERAGE LIMITS
16 OF NOT LESS THAN $1,000,000 PER OCCURRENCE OR LESS THAN
17 $4,500,000 PER ANNUAL AGGREGATE.
18 * * *
19 SECTION 712. MEDICAL CARE AVAILABILITY AND REDUCTION OF ERROR
20 FUND.
21 * * *
22 (C) FUND LIABILITY LIMITS.--
23 (1) FOR CALENDAR YEAR 2002, THE LIMIT OF LIABILITY OF
24 THE FUND CREATED IN SECTION 701(D) OF THE FORMER HEALTH CARE
25 SERVICES MALPRACTICE ACT FOR EACH HEALTH CARE PROVIDER THAT
26 CONDUCTS MORE THAN 50% OF ITS HEALTH CARE BUSINESS OR
27 PRACTICE WITHIN THIS COMMONWEALTH AND FOR EACH HOSPITAL SHALL
28 BE $700,000 FOR EACH OCCURRENCE AND $2,100,000 PER ANNUAL
29 AGGREGATE.
30 (2) THE LIMIT OF LIABILITY OF THE FUND FOR EACH
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1 PARTICIPATING HEALTH CARE PROVIDER SHALL BE AS FOLLOWS:
2 (I) FOR CALENDAR YEAR 2003 AND EACH YEAR THEREAFTER,
3 THE LIMIT OF LIABILITY OF THE FUND SHALL BE $500,000 FOR
4 EACH OCCURRENCE AND $1,500,000 PER ANNUAL AGGREGATE.
5 (II) IF THE BASIC INSURANCE COVERAGE REQUIREMENT IS
6 INCREASED IN ACCORDANCE WITH SECTION 711(D)(3) OR (4)
7 AND, NOTWITHSTANDING SUBPARAGRAPH (I), FOR EACH CALENDAR
8 YEAR FOLLOWING THE INCREASE IN THE BASIC INSURANCE
9 COVERAGE REQUIREMENT, THE LIMIT OF LIABILITY OF THE FUND
10 SHALL BE [$250,000 FOR EACH OCCURRENCE AND $750,000 PER
11 ANNUAL AGGREGATE.
12 (III) IF THE BASIC INSURANCE COVERAGE REQUIREMENT IS
13 INCREASED IN ACCORDANCE WITH SECTION 711(D)(4) AND,
14 NOTWITHSTANDING SUBPARAGRAPHS (I) AND (II), FOR EACH
15 CALENDAR YEAR FOLLOWING THE INCREASE IN THE BASIC
16 INSURANCE COVERAGE REQUIREMENT, THE LIMIT OF LIABILITY OF
17 THE FUND SHALL BE ZERO.] $1,000,000 PER OCCURRENCE AND
18 $3,000,000 PER ANNUAL AGGREGATE, EXCEPT HOSPITALS WHICH
19 SHALL BE $1,000,000 PER OCCURRENCE AND $4,500,000 PER
20 ANNUAL AGGREGATE, MINUS THE AMOUNT THE COMMISSIONER
21 DETERMINES FOR BASIC INSURANCE COVERAGE UNDER SECTION
22 711(D)(3) OR (4).
23 * * *
24 SECTION 745. ACTUARIAL DATA.
25 (A) INITIAL STUDY.--THE FOLLOWING SHALL APPLY:
26 (1) NO LATER THAN APRIL 1, 2005, EACH INSURER PROVIDING
27 MEDICAL PROFESSIONAL LIABILITY INSURANCE IN THIS COMMONWEALTH
28 SHALL FILE LOSS DATA AS REQUIRED BY THE COMMISSIONER. FOR
29 FAILURE TO COMPLY, THE COMMISSIONER SHALL IMPOSE AN
30 ADMINISTRATIVE PENALTY OF $1,000 FOR EVERY DAY THAT THIS DATA
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1 IS NOT PROVIDED IN ACCORDANCE WITH THIS PARAGRAPH.
2 (2) BY JULY 1, 2005, THE COMMISSIONER SHALL CONDUCT A
3 STUDY REGARDING THE AVAILABILITY OF ADDITIONAL BASIC
4 INSURANCE COVERAGE CAPACITY. THE STUDY SHALL INCLUDE AN
5 ESTIMATE OF THE TOTAL CHANGE IN MEDICAL PROFESSIONAL
6 LIABILITY INSURANCE LOSS-COST RESULTING FROM IMPLEMENTATION
7 OF THIS ACT PREPARED BY AN INDEPENDENT ACTUARY. THE FEE FOR
8 THE INDEPENDENT ACTUARY SHALL BE BORNE BY THE FUND. IN
9 DEVELOPING THE ESTIMATE, THE INDEPENDENT ACTUARY SHALL
10 CONSIDER ALL OF THE FOLLOWING:
11 (I) THE MOST RECENT ACCIDENT YEAR AND RATEMAKING
12 DATA AVAILABLE.
13 (II) ANY OTHER RELEVANT FACTORS WITHIN OR OUTSIDE
14 THIS COMMONWEALTH IN ACCORDANCE WITH SOUND ACTUARIAL
15 PRINCIPLES.
16 (B) ADDITIONAL STUDY.--THE FOLLOWING SHALL APPLY:
17 (1) [THREE YEARS FOLLOWING] PURSUANT TO SECTION
18 711(D)(3) OR (4), THE COMMISSIONER SHALL CONDUCT A STUDY
19 REGARDING THE AVAILABILITY OF ADDITIONAL BASIC INSURANCE
20 COVERAGE CAPACITY AS SET FORTH IN THIS SUBSECTION. IN ORDER
21 FOR THE COMMISSIONER TO MAKE A FINAL DETERMINATION REGARDING
22 THE INCREASE OF THE BASIC INSURANCE COVERAGE REQUIREMENT IN
23 ACCORDANCE WITH SECTION 711(D)(3) OR (4), EACH INSURER
24 PROVIDING MEDICAL PROFESSIONAL LIABILITY INSURANCE IN THIS
25 COMMONWEALTH SHALL FILE LOSS DATA WITH THE COMMISSIONER UPON
26 REQUEST. FOR FAILURE TO COMPLY, THE COMMISSIONER SHALL IMPOSE
27 AN ADMINISTRATIVE PENALTY OF $1,000 FOR EVERY DAY THAT THIS
28 DATA IS NOT PROVIDED IN ACCORDANCE WITH THIS PARAGRAPH.
29 (2) THREE MONTHS FOLLOWING THE REQUEST MADE UNDER
30 PARAGRAPH (1), THE COMMISSIONER SHALL CONDUCT A STUDY
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1 REGARDING THE AVAILABILITY OF ADDITIONAL BASIC INSURANCE
2 COVERAGE CAPACITY. THE STUDY SHALL INCLUDE AN ESTIMATE OF THE
3 TOTAL CHANGE IN MEDICAL PROFESSIONAL LIABILITY INSURANCE
4 LOSS-COST RESULTING FROM IMPLEMENTATION OF THIS ACT PREPARED
5 BY AN INDEPENDENT ACTUARY. THE FEE FOR THE INDEPENDENT
6 ACTUARY SHALL BE BORNE BY THE FUND. IN DEVELOPING THE
7 ESTIMATE, THE INDEPENDENT ACTUARY SHALL CONSIDER ALL OF THE
8 FOLLOWING:
9 (I) THE MOST RECENT ACCIDENT YEAR AND RATEMAKING
10 DATA AVAILABLE.
11 (II) ANY OTHER RELEVANT FACTORS INCLUDING ECONOMIC
12 CONSIDERATIONS WITHIN OR OUTSIDE THIS COMMONWEALTH IN
13 ACCORDANCE WITH SOUND ACTUARIAL PRINCIPLES.
14 (3) UPON REVIEW OF THE STUDY BY THE COMMISSIONER, A
15 FINAL DETERMINATION SHALL BE ISSUED BY THE COMMISSIONER BY
16 JULY 1, 2008, AND BY JULY 1 OF EACH YEAR THEREAFTER IF A
17 STUDY IS REQUIRED PURSUANT TO SECTION 711(D)(3) OR (4).
18 SECTION 2. CHAPTER 7 OF THE ACT IS AMENDED BY ADDING
19 SUBCHAPTERS TO READ:
20 SUBCHAPTER E
21 MEDICAL CARE AVAILABILITY AND REDUCTION OF ERROR
22 (MCARE) RESERVE FUND
23 SECTION 751. ESTABLISHMENT.
24 THERE IS ESTABLISHED WITHIN THE STATE TREASURY A SPECIAL FUND
25 TO BE KNOWN AS THE MEDICAL CARE AVAILABILITY AND REDUCTION OF
26 ERROR (MCARE) RESERVE FUND.
27 SECTION 752. ALLOCATION.
28 MONEY IN THE MEDICAL CARE AVAILABILITY AND REDUCTION OF ERROR
29 (MCARE) RESERVE FUND SHALL BE ALLOCATED ANNUALLY AS FOLLOWS:
30 (1) TWENTY-FIVE PERCENT OF THE TOTAL AMOUNT IN THE
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1 MEDICAL CARE AVAILABILITY AND REDUCTION OF ERROR (MCARE)
2 RESERVE FUND, UP TO A MAXIMUM AMOUNT OF $25,000,000, SHALL BE
3 TRANSFERRED TO THE PATIENT SAFETY TRUST FUND FOR USE BY THE
4 DEPARTMENT OF PUBLIC WELFARE FOR IMPLEMENTING SECTION 407.
5 (2) TWENTY-FIVE PERCENT OF THE TOTAL AMOUNT IN THE
6 MEDICAL CARE AVAILABILITY AND REDUCTION OF ERROR (MCARE)
7 RESERVE FUND, UP TO A MAXIMUM AMOUNT OF $25,000,000, SHALL BE
8 TRANSFERRED TO THE MEDICAL SAFETY AUTOMATION FUND.
9 (3) ALL OTHER FUNDS IN THE MEDICAL CARE AVAILABILITY AND
10 REDUCTION OF ERROR (MCARE) RESERVE FUND SHALL REMAIN IN THE
11 MEDICAL CARE AVAILABILITY AND REDUCTION OF ERROR (MCARE)
12 RESERVE FUND FOR THE SOLE PURPOSE OF REDUCING THE UNFUNDED
13 LIABILITY OF THE FUND.
14 SUBCHAPTER F
15 MEDICAL SAFETY AUTOMATION FUND
16 SECTION 762. MEDICAL SAFETY AUTOMATION FUND ESTABLISHED.
17 THERE IS ESTABLISHED WITHIN THE STATE TREASURY A SPECIAL FUND
18 TO BE KNOWN AS THE MEDICAL SAFETY AUTOMATION FUND. NO MONEY IN
19 THE MEDICAL SAFETY AUTOMATION FUND SHALL BE USED UNTIL
20 LEGISLATION IS ENACTED FOR THE PURPOSE OF PROVIDING MEDICAL
21 SAFETY AUTOMATION SYSTEM GRANTS TO HEALTH CARE PROVIDERS UNDER
22 THE ACT OF JULY 19, 1979 (P.L.130, NO.48), KNOWN AS THE HEALTH
23 CARE FACILITIES ACT, A GROUP PRACTICE OR A COMMUNITY-BASED
24 HEALTH CARE PROVIDER.
25 SECTION 2.1. THE ACT IS AMENDED BY ADDING A CHAPTER TO READ:
26 CHAPTER 10
27 VOLUNTEER HEALTH SERVICES
28 SECTION 1001. SCOPE.
29 THIS CHAPTER RELATES TO VOLUNTEER HEALTH SERVICES.
30 SECTION 1002. PURPOSE.
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1 IT IS THE PURPOSE OF THIS CHAPTER TO INCREASE THE
2 AVAILABILITY OF PRIMARY HEALTH CARE SERVICES BY ESTABLISHING A
3 PROCEDURE THROUGH WHICH PHYSICIANS AND OTHER HEALTH CARE
4 PRACTITIONERS WHO ARE RETIRED FROM ACTIVE PRACTICE MAY PROVIDE
5 PROFESSIONAL SERVICES AS A VOLUNTEER IN APPROVED CLINICS SERVING
6 FINANCIALLY QUALIFIED PERSONS AND IN APPROVED CLINICS LOCATED IN
7 MEDICALLY UNDERSERVED AREAS OR HEALTH PROFESSIONALS SHORTAGE
8 AREAS.
9 SECTION 1003. DEFINITIONS.
10 THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS CHAPTER
11 SHALL HAVE THE MEANINGS GIVEN TO THEM IN THIS SECTION UNLESS THE
12 CONTEXT CLEARLY INDICATES OTHERWISE:
13 "APPROVED CLINIC." AN ORGANIZED COMMUNITY-BASED CLINIC
14 OFFERING PRIMARY HEALTH CARE SERVICES TO INDIVIDUALS AND
15 FAMILIES WHO CANNOT PAY FOR THEIR CARE, TO MEDICAL ASSISTANCE
16 CLIENTS OR TO RESIDENTS OF MEDICALLY UNDERSERVED AREAS OR HEALTH
17 PROFESSIONALS SHORTAGE AREAS. THE TERM MAY INCLUDE, BUT SHALL
18 NOT BE LIMITED TO, A STATE HEALTH CENTER, NONPROFIT COMMUNITY-
19 BASED CLINIC AND FEDERALLY QUALIFIED HEALTH CENTER, AS
20 DESIGNATED BY FEDERAL RULEMAKING OR AS APPROVED BY THE
21 DEPARTMENT OF HEALTH OR THE DEPARTMENT OF PUBLIC WELFARE.
22 "BOARD." THE STATE BOARD OF MEDICINE, THE STATE BOARD OF
23 OSTEOPATHIC MEDICINE, THE STATE BOARD OF DENTISTRY, THE STATE
24 BOARD OF PODIATRY, THE STATE BOARD OF NURSING, THE STATE BOARD
25 OF OPTOMETRY AND THE STATE BOARD OF CHIROPRACTIC.
26 "HEALTH CARE PRACTITIONER." AN INDIVIDUAL LICENSED TO
27 PRACTICE A COMPONENT OF THE HEALING ARTS BY A LICENSING BOARD
28 WITHIN THE DEPARTMENT OF STATE.
29 "LICENSEE." AN INDIVIDUAL WHO HOLDS A CURRENT, ACTIVE,
30 UNRESTRICTED LICENSE AS A HEALTH CARE PRACTITIONER ISSUED BY THE
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1 APPROPRIATE BOARD.
2 "PRIMARY HEALTH CARE SERVICES." THE TERM INCLUDES, BUT IS
3 NOT LIMITED TO, REGULAR CHECKUPS, IMMUNIZATIONS, SCHOOL
4 PHYSICALS, HEALTH EDUCATION, PRENATAL AND OBSTETRICAL CARE,
5 EARLY PERIODIC SCREENING AND DIAGNOSTIC TESTING AND HEALTH
6 EDUCATION.
7 "VOLUNTEER LICENSE." A LICENSE ISSUED BY THE APPROPRIATE
8 BOARD TO A HEALTH CARE PRACTITIONER WHO DOCUMENTS, TO THE
9 BOARD'S SATISFACTION, THAT THE INDIVIDUAL WILL PRACTICE ONLY IN
10 APPROVED CLINICS WITHOUT REMUNERATION, WHO IS:
11 (1) A RETIRED HEALTH CARE PRACTITIONER; OR
12 (2) A NONRETIRED HEALTH CARE PRACTITIONER WHO IS NOT
13 REQUIRED TO MAINTAIN PROFESSIONAL LIABILITY INSURANCE UNDER
14 CHAPTER 7, BECAUSE THE HEALTH CARE PRACTITIONER IS NOT
15 OTHERWISE PRACTICING MEDICINE OR PROVIDING HEALTH CARE
16 SERVICES IN THIS COMMONWEALTH.
17 SECTION 1004. VOLUNTEER STATUS.
18 A LICENSEE IN GOOD STANDING WHO RETIRES FROM ACTIVE PRACTICE
19 OR A NONRETIRED LICENSEE WHO DOES NOT OTHERWISE CURRENTLY
20 PRACTICE OR PROVIDE HEALTH CARE SERVICES IN THIS COMMONWEALTH
21 AND IS NOT REQUIRED TO MAINTAIN PROFESSIONAL LIABILITY INSURANCE
22 UNDER CHAPTER 7 MAY APPLY, ON FORMS PROVIDED BY THE APPROPRIATE
23 BOARD, FOR A VOLUNTEER LICENSE.
24 SECTION 1005. REGULATIONS.
25 EACH BOARD SHALL PROMULGATE REGULATIONS GOVERNING THE
26 VOLUNTEER LICENSE CATEGORY. THE REGULATIONS SHALL INCLUDE
27 QUALIFICATIONS FOR OBTAINING A VOLUNTEER LICENSE.
28 SECTION 1006. LICENSE RENEWAL; DISCIPLINARY AND CORRECTIVE
29 MEASURES.
30 (A) RENEWAL TERM.--A VOLUNTEER LICENSE SHALL BE SUBJECT TO
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1 BIENNIAL RENEWAL.
2 (B) FEE EXEMPTION.--HOLDERS OF VOLUNTEER LICENSES SHALL BE
3 EXEMPT FROM RENEWAL FEES IMPOSED BY THE APPROPRIATE LICENSING
4 BOARD.
5 (C) CONTINUING EDUCATION.--EXCEPT AS SET FORTH IN SUBSECTION
6 (D), HOLDERS OF VOLUNTEER LICENSES SHALL COMPLY WITH ANY
7 CONTINUING EDUCATION REQUIREMENTS IMPOSED BY BOARD RULEMAKING AS
8 A GENERAL CONDITION OF BIENNIAL RENEWAL.
9 (D) PHYSICIANS.--
10 (1) HOLDERS OF VOLUNTEER LICENSES WHO ARE PHYSICIANS
11 SHALL COMPLETE A MINIMUM OF 20 CREDIT HOURS OF AMERICAN
12 MEDICAL ASSOCIATION PHYSICIAN'S RECOGNITION AWARD CATEGORY 2
13 ACTIVITIES DURING THE PRECEDING BIENNIAL PERIOD AS A
14 CONDITION OF BIENNIAL RENEWAL AND ARE OTHERWISE EXEMPT FROM
15 ANY CONTINUING EDUCATION REQUIREMENT IMPOSED BY SECTION 910,
16 OR BY BOARD RULEMAKING.
17 (2) PHYSICIANS WHO ARE COVERED BY SECTION 1010.2 AND
18 HOLD AN UNRESTRICTED LICENSE TO PRACTICE MEDICINE SHALL
19 COMPLETE THE CONTINUING MEDICAL EDUCATION REQUIREMENTS
20 ESTABLISHED BY THE BOARDS UNDER SECTION 910 TO BE ELIGIBLE
21 FOR RENEWAL OF THE UNRESTRICTED LICENSE.
22 (D.1) NURSES.--HOLDERS OF VOLUNTEER LICENSES who are nurses
23 shall complete a minimum of 20 credit hours of continuing
24 education during the preceding biennial period as a condition of
25 biennial renewal and are otherwise exempt from any continuing
26 education requirements imposed by section 12.1 of the act of May
27 22, 1951 (P.L.317, No.69), known as The Professional Nursing
28 Law, as a condition of biennial renewal.
29 (e) Disciplinary matters.--In the enforcement of <--
30 disciplinary matters, holders of volunteer licenses shall be
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1 subject to those standards of conduct applicable to all
2 licensees licensed by the appropriate board.
3 Section 2. This act shall take effect in 60 days.
4 (E) DISCIPLINARY MATTERS.--IN THE ENFORCEMENT OF <--
5 DISCIPLINARY MATTERS, HOLDERS OF VOLUNTEER LICENSES SHALL BE
6 SUBJECT TO THOSE STANDARDS OF CONDUCT APPLICABLE TO ALL
7 LICENSEES LICENSED BY THE APPROPRIATE BOARD.
8 SECTION 1007. LIABILITY.
9 (A) GENERAL RULE.--A HOLDER OF A VOLUNTEER LICENSE WHO, IN
10 GOOD FAITH, RENDERS PROFESSIONAL HEALTH CARE SERVICES UNDER THIS
11 CHAPTER SHALL NOT BE LIABLE FOR CIVIL DAMAGES ARISING AS A
12 RESULT OF ANY ACT OR OMISSION IN THE RENDERING OF CARE UNLESS
13 THE CONDUCT OF THE VOLUNTEER LICENSEE FALLS SUBSTANTIALLY BELOW
14 PROFESSIONAL STANDARDS WHICH ARE GENERALLY PRACTICED AND
15 ACCEPTED IN THE COMMUNITY AND UNLESS IT IS SHOWN THAT THE
16 VOLUNTEER LICENSEE DID AN ACT OR OMITTED THE DOING OF AN ACT
17 WHICH THE PERSON WAS UNDER A RECOGNIZED DUTY TO A PATIENT TO DO,
18 KNOWING OR HAVING REASON TO KNOW THAT THE ACT OR OMISSION
19 CREATED A SUBSTANTIAL RISK OF ACTUAL HARM TO THE PATIENT.
20 (B) APPLICATION.--THIS SECTION SHALL NOT APPLY UNLESS THE
21 APPROVED CLINIC POSTS IN A CONSPICUOUS PLACE ON ITS PREMISES AN
22 EXPLANATION OF THE EXEMPTIONS FROM CIVIL LIABILITY PROVIDED
23 UNDER SUBSECTION (A). THE PROTECTIONS PROVIDED BY THIS SECTION
24 SHALL NOT APPLY TO INSTITUTIONAL HEALTH CARE PROVIDERS, SUCH AS
25 HOSPITALS OR APPROVED CLINICS, SUBJECT TO VICARIOUS LIABILITY
26 FOR THE CONDUCT OF A VOLUNTEER LICENSE HOLDER. THE LIABILITY OF
27 SUCH INSTITUTIONAL DEFENDANTS SHALL BE GOVERNED BY THE STANDARD
28 OF CARE ESTABLISHED BY COMMON LAW.
29 SECTION 1008. REPORT.
30 BEGINNING MARCH 5, 1997, AND EVERY 30 DAYS THEREAFTER UNTIL
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1 SUCH REGULATIONS ARE IN EFFECT, THE CHAIRMEN OF THE APPROPRIATE
2 BOARDS SHALL REPORT IN WRITING TO THE COMMISSIONER OF
3 PROFESSIONAL AND OCCUPATIONAL AFFAIRS ON THE STATUS OF THE
4 VOLUNTEER LICENSE REGULATIONS, WHO SHALL CONVEY THE REQUIRED
5 REPORTS TO THE CONSUMER PROTECTION AND PROFESSIONAL LICENSURE
6 COMMITTEE AND THE PUBLIC HEALTH AND WELFARE COMMITTEE OF THE
7 SENATE AND THE PROFESSIONAL LICENSURE COMMITTEE AND THE HEALTH
8 AND HUMAN SERVICES COMMITTEE OF THE HOUSE OF REPRESENTATIVES.
9 SECTION 1009. EXEMPTIONS.
10 FOR THE PURPOSES OF THIS CHAPTER, VOLUNTEER LICENSEES WHO ARE
11 OTHERWISE SUBJECT TO THE PROVISIONS OF CHAPTER 7 SHALL BE EXEMPT
12 FROM THE REQUIREMENTS OF THAT ACT WITH REGARD TO THE MAINTENANCE
13 OF LIABILITY INSURANCE COVERAGE. VOLUNTEER LICENSEES HOLDING A
14 LICENSE ISSUED BY THE STATE BOARD OF CHIROPRACTIC SHALL BE
15 EXEMPT FROM THE PROVISIONS OF SECTION 508 OF THE ACT OF DECEMBER
16 16, 1986 (P.L.1646, NO.188), KNOWN AS THE CHIROPRACTIC PRACTICE
17 ACT.
18 SECTION 1010. STATE HEALTH CENTERS.
19 SERVICES OF VOLUNTEERS SHALL NOT BE SUBSTITUTED FOR THOSE OF
20 COMMONWEALTH EMPLOYEES.
21 SECTION 1010.1. PRESCRIPTION OF MEDICATION FOR FAMILY MEMBERS.
22 (A) GENERAL RULE.--A HOLDER OF A VOLUNTEER LICENSE WHO WAS
23 ABLE TO PRESCRIBE MEDICATION PURSUANT TO THE LAWS OF THIS
24 COMMONWEALTH WHILE A LICENSEE MAY PRESCRIBE MEDICATION TO ANY
25 MEMBER OF HIS FAMILY NOTWITHSTANDING THE FAMILY MEMBER'S ABILITY
26 TO PAY FOR THAT MEMBER'S OWN CARE OR WHETHER THAT MEMBER IS
27 BEING TREATED AT AN APPROVED CLINIC.
28 (B) LIABILITY.--THE LIABILITY PROVISIONS OF SECTION 1007(A)
29 SHALL APPLY TO A HOLDER OF A VOLUNTEER LICENSE WHO PRESCRIBES
30 MEDICATION TO A FAMILY MEMBER PURSUANT TO THIS SECTION, WHETHER
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1 OR NOT THE PROVISIONS OF SECTION 1007(B) HAVE BEEN FOLLOWED.
2 (C) CONSTRUCTION.--NOTHING IN THIS SECTION SHALL BE
3 CONSTRUED TO ALLOW A VOLUNTEER LICENSE HOLDER TO PRESCRIBE
4 MEDICATION OF A TYPE OR IN A MANNER PROHIBITED BY THE LAWS OF
5 THIS COMMONWEALTH.
6 (D) DEFINITION.--AS USED IN THIS SECTION, THE TERM "FAMILY
7 MEMBER" MEANS A VOLUNTEER LICENSE HOLDER'S SPOUSE, CHILD,
8 DAUGHTER-IN-LAW, SON-IN-LAW, MOTHER, FATHER, SIBLING, MOTHER-IN-
9 LAW, FATHER-IN-LAW, SISTER-IN-LAW, BROTHER-IN-LAW, GRANDPARENT,
10 GRANDCHILD, NIECE, NEPHEW OR COUSIN.
11 SECTION 1010.2. INDEMNITY AND DEFENSE FOR ACTIVE PRACTITIONERS.
12 A HEALTH CARE PRACTITIONER WHO PROVIDES HEALTH CARE SERVICES
13 AT AN APPROVED CLINIC WITHOUT REMUNERATION UNDER AN ACTIVE
14 NONVOLUNTEER LICENSE SHALL BE ENTITLED TO INDEMNITY AND DEFENSE
15 UNDER THE TERMS OF WHATEVER LIABILITY INSURANCE COVERAGE IS
16 MAINTAINED BY OR PROVIDED TO THE PRACTITIONER TO COMPLY WITH
17 CHAPTER 7 IN THE SCOPE OF THEIR REGULAR PRACTICE. NO HEALTH CARE
18 PRACTITIONER MAY BE SURCHARGED OR DENIED COVERAGE FOR RENDERING
19 SERVICES AT AN APPROVED CLINIC. NOTHING SET FORTH IN THIS
20 SECTION SHALL LIMIT A CARRIER'S RIGHT TO REFUSE COVERAGE OR TO
21 ADJUST PREMIUMS ON THE BASIS OF MERITORIOUS CLAIMS AGAINST THE
22 PRACTITIONER.
23 SECTION 1010.3. OPTIONAL LIABILITY COVERAGE.
24 A HOLDER OF A VOLUNTEER LICENSE OR AN APPROVED CLINIC ACTING
25 ON BEHALF OF A VOLUNTEER LICENSEE WHO ELECTS TO PURCHASE PRIMARY
26 INSURANCE TO COVER SERVICES RENDERED AT AN APPROVED CLINIC SHALL
27 NOT BE OBLIGATED TO PURCHASE EXCESS COVERAGE THROUGH THE MEDICAL
28 CARE AVAILABILITY AND REDUCTION OF ERROR (MCARE) FUND.
29 SECTION 3. SECTION 1102 OF THE ACT, AMENDED OCTOBER 27, 2006
30 (P.L.1198, NO.128), IS AMENDED TO READ:
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1 SECTION 1102. ABATEMENT PROGRAM.
2 (A) ESTABLISHMENT.--THERE IS HEREBY ESTABLISHED WITHIN THE
3 INSURANCE DEPARTMENT A PROGRAM TO BE KNOWN AS THE HEALTH CARE
4 PROVIDER RETENTION PROGRAM. THE INSURANCE DEPARTMENT, IN
5 CONJUNCTION WITH THE DEPARTMENT OF PUBLIC WELFARE, SHALL
6 ADMINISTER THE PROGRAM. THE PROGRAM SHALL PROVIDE ASSISTANCE IN
7 THE FORM OF ASSESSMENT ABATEMENTS TO HEALTH CARE PROVIDERS FOR
8 CALENDAR YEARS 2003, 2004, 2005, 2006 [AND], 2007 AND 2008,
9 EXCEPT THAT LICENSED PODIATRISTS SHALL NOT BE ELIGIBLE FOR
10 CALENDAR YEARS 2003 AND 2004, AND NURSING HOMES SHALL NOT BE
11 ELIGIBLE FOR CALENDAR YEARS 2003, 2004 AND 2005.
12 (B) OTHER [ABATEMENT.--] ABATEMENTS.--
13 (1) EMERGENCY PHYSICIANS NOT EMPLOYED FULL TIME BY A
14 TRAUMA CENTER OR WORKING UNDER AN EXCLUSIVE CONTRACT WITH A
15 TRAUMA CENTER SHALL RETAIN ELIGIBILITY FOR AN ABATEMENT
16 PURSUANT TO SECTION 1104(B)(2) FOR CALENDAR YEARS 2003, 2004,
17 2005 AND 2006. COMMENCING IN CALENDAR YEAR 2007, THESE
18 EMERGENCY PHYSICIANS SHALL BE ELIGIBLE FOR AN ABATEMENT
19 PURSUANT TO SECTION 1104(B)(1).
20 (2) BIRTH CENTERS SHALL RETAIN ELIGIBILITY FOR ABATEMENT
21 PURSUANT TO SECTION 1104(B)(2) FOR CALENDAR YEARS 2003, 2004,
22 2005, 2006 AND 2007. COMMENCING IN CALENDAR YEAR 2008, BIRTH
23 CENTERS SHALL BE ELIGIBLE FOR AN ABATEMENT PURSUANT TO
24 SECTION 1104(B)(1).
25 SECTION 4. SECTION 1112 OF THE ACT, ADDED DECEMBER 22, 2005
26 (P.L.458, NO.88), IS AMENDED TO READ:
27 SECTION 1112. HEALTH CARE PROVIDER RETENTION ACCOUNT.
28 (A) FUND ESTABLISHED.--THERE IS ESTABLISHED WITHIN THE
29 GENERAL FUND A SPECIAL ACCOUNT TO BE KNOWN AS THE HEALTH CARE
30 PROVIDER RETENTION ACCOUNT. FUNDS IN THE ACCOUNT SHALL BE
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1 SUBJECT TO AN ANNUAL APPROPRIATION BY THE GENERAL ASSEMBLY TO
2 THE DEPARTMENT OF PUBLIC WELFARE. THE DEPARTMENT OF PUBLIC
3 WELFARE SHALL ADMINISTER FUNDS APPROPRIATED UNDER THIS SECTION
4 CONSISTENT WITH ITS DUTIES UNDER SECTION 201(1) OF THE ACT OF
5 JUNE 13, 1967 (P.L.31, NO.21), KNOWN AS THE PUBLIC WELFARE CODE.
6 (B) TRANSFERS FROM MCARE FUND.--BY DECEMBER 31 OF EACH YEAR,
7 THE SECRETARY OF THE BUDGET MAY TRANSFER FROM THE MEDICAL CARE
8 AVAILABILITY AND REDUCTION OF ERROR (MCARE) FUND ESTABLISHED IN
9 SECTION 712(A) TO THE ACCOUNT AN AMOUNT EQUAL TO THE DIFFERENCE
10 BETWEEN THE AMOUNT DEPOSITED UNDER SECTION 712(M) AND THE AMOUNT
11 GRANTED AS DISCOUNTS UNDER SECTION 712(E)(2) FOR THAT CALENDAR
12 YEAR.
13 (C) TRANSFERS FROM ACCOUNT.--THE SECRETARY OF THE BUDGET MAY
14 ANNUALLY TRANSFER FROM THE ACCOUNT TO THE MEDICAL CARE
15 AVAILABILITY AND REDUCTION OF ERROR (MCARE) FUND AN AMOUNT UP TO
16 THE AGGREGATE AMOUNT OF ABATEMENTS GRANTED BY THE INSURANCE
17 DEPARTMENT UNDER SECTION 1104(B).
18 (C.1) TRANSFERS TO THE MEDICAL CARE AVAILABILITY AND
19 REDUCTION OF ERROR (MCARE) RESERVE FUND.--ANY FUNDS REMAINING IN
20 THE ACCOUNT AFTER THE SECRETARY OF THE BUDGET MAKES THE TRANSFER
21 UNDER SUBSECTION (C) SHALL BE TRANSFERRED TO THE MEDICAL CARE
22 AVAILABILITY AND REDUCTION OF ERROR (MCARE) RESERVE FUND.
23 (D) OTHER DEPOSITS.--THE DEPARTMENT OF PUBLIC WELFARE MAY
24 DEPOSIT ANY OTHER FUNDS RECEIVED BY THE DEPARTMENT WHICH IT
25 DEEMS APPROPRIATE IN THE ACCOUNT.
26 (E) ADMINISTRATION ASSISTANCE.--THE INSURANCE DEPARTMENT
27 SHALL PROVIDE ASSISTANCE TO THE DEPARTMENT OF PUBLIC WELFARE IN
28 ADMINISTERING THE ACCOUNT.
29 SECTION 5. SECTION 1115 OF THE ACT, AMENDED OCTOBER 27, 2006
30 (P.L.1198, NO.128), IS AMENDED TO READ:
20070H0489B2983 - 17 -
1 SECTION 1115. EXPIRATION.
2 THE HEALTH CARE PROVIDER RETENTION PROGRAM ESTABLISHED UNDER
3 THIS CHAPTER SHALL EXPIRE DECEMBER 31, [2008] 2009.
4 SECTION 6. SECTION 5106 OF THE ACT IS AMENDED TO READ:
5 SECTION 5106. EXPIRATION.
6 SECTION 312 SHALL EXPIRE ON DECEMBER 31, [2007] 2008.
7 SECTION 6.1. REPEALS ARE AS FOLLOWS:
8 (1) THE GENERAL ASSEMBLY DECLARES THAT THE REPEAL UNDER
9 PARAGRAPH (2) IS NECESSARY TO EFFECTUATE THE ADDITION OF
10 CHAPTER 10 OF THE ACT.
11 (2) THE ACT OF DECEMBER 4, 1996 (P.L.893, NO.141), KNOWN
12 AS THE VOLUNTEER HEALTH SERVICES ACT, IS REPEALED.
13 SECTION 6.2. THE ADDITION OF CHAPTER 10 OF THE ACT IS A
14 CONTINUATION OF THE ACT OF DECEMBER 4, 1996 (P.L.893, NO.141),
15 KNOWN AS THE VOLUNTEER HEALTH SERVICES ACT. THE FOLLOWING APPLY:
16 (1) EXCEPT AS OTHERWISE PROVIDED IN CHAPTER 10 OF THE
17 ACT, ALL ACTIVITIES INITIATED UNDER THE VOLUNTEER HEALTH
18 SERVICES ACT SHALL CONTINUE AND REMAIN IN FULL FORCE AND
19 EFFECT AND MAY BE COMPLETED UNDER CHAPTER 10 OF THE ACT.
20 ORDERS, REGULATIONS, RULES AND DECISIONS WHICH WERE MADE
21 UNDER THE VOLUNTEER HEALTH SERVICES ACT AND WHICH ARE IN
22 EFFECT ON THE EFFECTIVE DATE OF SECTION 6.1 OF THIS ACT SHALL
23 REMAIN IN FULL FORCE AND EFFECT UNTIL REVOKED, VACATED OR
24 MODIFIED UNDER CHAPTER 10 OF THE ACT. CONTRACTS, OBLIGATIONS
25 AND COLLECTIVE BARGAINING AGREEMENTS ENTERED INTO UNDER THE
26 VOLUNTEER HEALTH SERVICES ACT ARE NOT AFFECTED NOR IMPAIRED
27 BY THE REPEAL OF THE VOLUNTEER HEALTH SERVICES ACT.
28 (2) EXCEPT AS SET FORTH IN PARAGRAPH (3), ANY DIFFERENCE
29 IN LANGUAGE BETWEEN CHAPTER 10 OF THE ACT AND THE VOLUNTEER
30 HEALTH SERVICES ACT IS INTENDED ONLY TO CONFORM TO THE STYLE
20070H0489B2983 - 18 -
1 OF THE ACT AND IS NOT INTENDED TO CHANGE OR AFFECT THE
2 LEGISLATIVE INTENT, JUDICIAL CONSTRUCTION OR ADMINISTRATION
3 AND IMPLEMENTATION OF THE VOLUNTEER HEALTH SERVICES ACT.
4 (3) PARAGRAPH (2) DOES NOT APPLY TO THE ADDITION OF
5 SECTION 1006(D.1) OF THE ACT.
6 SECTION 7. THIS ACT SHALL TAKE EFFECT AS FOLLOWS:
7 (1) THE ADDITION OF SECTION 1006(D.1) OF THE ACT SHALL
8 TAKE EFFECT IN 60 DAYS.
9 (2) THE REMAINDER OF THIS ACT SHALL TAKE EFFECT
10 IMMEDIATELY.
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