Medical malpractice insurance covers healthcare providers from claims arising from their practice. In Pennsylvania, healthcare providers need to understand some of the nuances of this insurance as coverage requirements are slightly different than in other states.

Coverage and Requirements in Pennsylvania

In Pennsylvania, medical malpractice insurance is mandated by law for practicing healthcare providers. The state requires minimum coverage limits, which healthcare professionals must adhere to. Understanding these requirements is crucial for compliance and protection.

Telemedicine Malpractice Insurance in Pennsylvania

Medical Care Availability and Reduction of Error Fund (MCARE) is the state's patient compensation fund and is mandatory for all providers that spend 50% or more of their practice in the state of Pennsylvania. Therefore, if your Pennsylvania telemedicine practice is 50% or less of your total practice then participation is not required. Providers seeing patients in Pennsylvania must comply with some MCARE requirements even if exempt. Filing the reason for exemption should be done here.

Please note that Pennsylvania requires separate $1,000,000/$3,000,000 limits for each provider. This feature is usually not the default for most insurance policies therefore make sure and review your policy closely.

Tort Reform in Pennsylvania

Pennsylvania implements tort reform for medical malpractice using several different mechanisms. The measures to control malpractice insurance costs while providing fair compensation to patients include:

• Pennsylvania does not have a cap on non-economic damages in medical malpractice cases, but there have been discussions and proposals around this issue.
• Pennsylvania requires a certificate of merit which means a qualified expert must certify that the medical provider's care fell below the acceptable standard.
• HB 1802 (2002) prevents patients from suing for damages that were already paid
• H.B. 1718 (2003) limits the amount a signatory to the Master Settlement Agreement can pay
• SB 1131 (2011) prohibits the application of the rule of joint and several
• HB 2210 (1996) limits punitive damages to 200% of compensatory awards

Required Insurance Limits

Pennsylvania mandates specific minimum coverage with a total of $1,000,000/$3,000,000 separate limits for each provider including Allied providers. If the provider is participating in MCARE then $500,000/$1,500,000 is required by the private insurance and the remaining $500,000/$1,500,000 is covered by MCARE.

These limits are designed to ensure that there are sufficient funds to cover potential claims and to provide a safety net for both patients and healthcare providers.

MCARE Fund

The Medical Care Availability and Reduction of Error (MCARE) Fund is a state-administered patient compensation fund designed to ensure compensation for patients injured by medical malpractice while also making malpractice insurance more affordable for healthcare providers. Key aspects of MCARE include:

• Required for Providers with more than 50% of the practice in Pennsylvania
• Healthcare providers contribute to the MCARE Fund through annual surcharges on their primary malpractice insurance policies.
• MCARE Fund provides excess coverage above the required primary insurance limits, offering additional protection for large claims.

Choosing the Right Policy

When selecting a medical malpractice insurance policy, healthcare providers should consider their specific needs, the reputation of the insurer, and the terms of the policy. Consulting with an insurance broker or legal advisor can help in making an informed decision.