1Amending the act of March 20, 2002 (P.L.154, No.13), entitled
2"An act reforming the law on medical professional liability;
3providing for patient safety and reporting; establishing the
4Patient Safety Authority and the Patient Safety Trust Fund;
5abrogating regulations; providing for medical professional
6liability informed consent, damages, expert qualifications,
7limitations of actions and medical records; establishing the
8Interbranch Commission on Venue; providing for medical
9professional liability insurance; establishing the Medical
10Care Availability and Reduction of Error Fund; providing for
11medical professional liability claims; establishing the Joint
12Underwriting Association; regulating medical professional
13liability insurance; providing for medical licensure
14regulation; providing for administration; imposing penalties;
15and making repeals," further providing for medical
16professional liability insurance, for the Medical Care
17Availability and Reduction of Error Fund; and establishing
18the Health Care Provider Rate Stabilization Fund.

19The General Assembly of the Commonwealth of Pennsylvania
20hereby enacts as follows:

21Section 1. Section 711(d)(3) and (4) of the act of March 20, 
222002 (P.L.154, No.13), known as the Medical Care Availability
23and Reduction of Error (Mcare) Act, are amended to read:

24Section 711. Medical professional liability insurance.

25* * *

26(d) Basic coverage limits.--A health care provider shall

1insure or self-insure medical professional liability in
2accordance with the following:

3* * *

4(3) [Unless the commissioner finds pursuant to section
5745(a) that additional basic insurance coverage capacity is
6not available, for] For policies issued or renewed in
7calendar [year 2006 and each year thereafter] years 2013, 
82014, 2015 and 2016 subject to paragraph (4), the basic
9insurance coverage shall be:

10(i) $750,000 per occurrence or claim and $2,250,000
11per annual aggregate for a participating health care
12provider that is not a hospital.

13(ii) $1,000,000 per occurrence or claim and
14$3,000,000 per annual aggregate for a nonparticipating
15health care provider.

16(iii) $750,000 per occurrence or claim and
17$3,750,000 per annual aggregate for a hospital.

18[If the commissioner finds pursuant to section 745(a) that
19additional basic insurance coverage capacity is not
20available, the basic insurance coverage requirements shall
21remain at the level required by paragraph (2); and the
22commissioner shall conduct a study every two years until the
23commissioner finds that additional basic insurance coverage
24capacity is available, at which time the commissioner shall
25increase the required basic insurance coverage in accordance
26with this paragraph.]

27(4) [Unless the commissioner finds pursuant to section
28745(b) that additional basic insurance coverage capacity is
29not available, for] For policies issued or renewed [three
30years after the increase in coverage limits required by

1paragraph (3)] in year 2017 and for each year thereafter, the
2basic insurance coverage shall be:

3(i) $1,000,000 per occurrence or claim and
4$3,000,000 per annual aggregate for a participating
5health care 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
8health care provider.

9(iii) $1,000,000 per occurrence or claim and
10$4,500,000 per annual aggregate for a hospital.

11[If the commissioner finds pursuant to section 745(b) that
12additional basic insurance coverage capacity is not
13available, the basic insurance coverage requirements shall
14remain at the level required by paragraph (3); and the
15commissioner shall conduct a study every two years until the
16commissioner finds that additional basic insurance coverage
17capacity is available, at which time the commissioner shall
18increase the required basic insurance coverage in accordance
19with this paragraph.]

20* * *

21Section 2. Section 712(d) of the act is amended by adding a
22paragraph to read:

23Section 712. Medical Care Availability and Reduction of Error
24Fund.

25* * *

26(d) Assessments.--

27* * *

28(4) For calendar year 2017 and for each calendar year
29thereafter, all assessments shall cease and the fund shall be
30funded in accordance with section 5102.1.

1* * *

2Section 3. The act is amended by adding a section to read:

3Section 5102.1. Health Care Provider Rate Stabilization Fund.

4(a) Declaration of policy.--The General Assembly finds and
5declares as follows:

6(1) Adequate numbers of health care providers for access
7to quality health care must be available.

8(2) Health care providers must be encouraged to practice
9in this Commonwealth.

10(3) The maintenance of a health care medical malpractice
11marketplace is essential to these goals.

12(4) The financial impact to health care providers as a
13result of the transition to a private medical malpractice
14marketplace must be mitigated.

15(b) Establishment.--Beginning January 1, 2013, the Health
16Care Provider Rate Stabilization Fund is established in the
17State Treasury. Money in the fund shall be used for the
18following purposes:

19(1) Payment of any obligations as described under this
20chapter.

21(2) Beginning January 1, 2017, payment of claims against
22any participating providers for losses or damages awarded in
23medical liability actions against them in accordance with
24section 712(c).

25(3) Payment of premiums and assessments for insurance
26coverage as required under sections 711(d) and 712(c) in
27effect for calendar year 2013 and each year thereafter until
28all liabilities of the fund have been eliminated, to the
29degree that the premiums and assessments are greater than
30110% of the premiums and assessments in effect during the

1previous calendar year. The commissioner shall determine the
2amount available for this purpose.

3(4) Payment of the patient safety discount as
4established under section 312. The amount available for this
5purpose shall be determined by the commissioner and shall
6only be authorized if there are sufficient funds available
7after satisfying the obligations under paragraphs (1), (2)
8and (3).

9(c) Responsibilities of commissioner.--In order to carry out
10this section, the commissioner shall:

11(1) Certify classes of health care providers by
12specialty, subspecialty or type of health care provider
13within a geographic classification, whose average medical
14malpractice premium, as a class, on or after January 1, 2013,
15is in excess of an amount per year as determined by the
16commissioner in accordance with subsection (b)(3).

17(2) Establish a methodology and procedures for
18determining eligibility for and providing payments from the
19fund in accordance with subsection (b)(3).

20(3) Upon certification of eligibility, the commission
21shall notify and send to the applicable health care
22provider's insurance carrier or self-insured program the
23appropriate amount from the fund, and the insurance carrier
24or self-insured provider shall provide a rebate or credit
25equal to the payment.

26(4) Take all necessary action to recover the cost of the
27subsidy provided to a health care provider that the
28commissioner determines to have been incorrectly provided.

29(d) Requirements of health care providers.--

30(1) A health care provider that fails to comply with the

1provisions of this section shall be required to repay to the
2commissioner the amount of the subsidy, in whole or in part,
3as determined by the commissioner.

4(2) A health care provider who has been subject to a
5disciplinary action or civil penalty by the practitioner's
6respective licensing board is not eligible for a subsidy from
7the fund.

8(e) Transfer of assets--The money in the Tobacco Settlement
9Fund is transferred to the fund beginning January 1, 2014.

10Section 4. This act shall take effect immediately.