How to avoid MCARE fund

[carrigallen]

I'm registering for Step 3, and I'm worried that if I register for the exam through Pennsylvania I will end up getting my unrestricted license in PA, and then having to pay part of my salary to MCARE.

On the other hand, if I get licensed in a nearby state, can I still use that license to work as a contract attending in PA during fellowship? Ie can I moonlight in PA with an unrestricted Delaware license during fellowship, and not have to enroll in MCARE? Just curious if anyone else has gone through this decision-making process.

 

[buckley]

if it's just for registring for the step 3, you dont have to worry about *where* for as long as you satisfy the requirement. everybody i know registered in connecticut...you dont have to get the license from where you registered...

 

[McDoctor]

I'm registering for Step 3, and I'm worried that if I register for the exam through Pennsylvania I will end up getting my unrestricted license in PA, and then having to pay part of my salary to MCARE.

On the other hand, if I get licensed in a nearby state, can I still use that license to work as a contract attending in PA during fellowship? Ie can I moonlight in PA with an unrestricted Delaware license during fellowship, and not have to enroll in MCARE? Just curious if anyone else has gone through this decision-making process.

😕You won't get an unrestricted license in PA unless you apply for one. Simple enough.

If only a small percentage of your time is spent practicing in pennsylvania, then you are potentially eligible for an exemption from MCARE. But for all intents and purposes, if you are going to practice in Pennsylvania, you'll probably need a license.

 

[Winged Scapula]

As a fellow in NJ, working as a moonlighter in Pennsylvania I was required to keep my PA license active. I suspect as a part-time employee who doesn't pay their own malpractice you will qualify for MCARE exemption. I haven't paid a cent toward it.

 

[johankriek]

what is the mcare fund?

 

[Winged Scapula]

what is the mcare fund?

http://www.pmslic.com/policyholders/mcarefund.asp

Essentially a state fund to provide increased coverage for practioners in state where the malpractice coverage and the payouts are ridiculously high.

Malpractice insurance is required in Pennsylvania (ie, you cannot go bare). However, insurance companies were not underwriting enough coverage to practice in Pennsylvania and cover the amount of the payouts the juries were awarding. So you could have malpractice insurance, but it wouldn't be enough to cover you, especially in markets like Philly. The physician then was responsible for the outlying amount...an untenable situation which caused physicians to lose their practices and which is unfriendly to the young physician starting out.

Thus, the MCARE fund was developed to help physicians in those areas where the jury awards commonly outstripped what they could purchase on the commercial market in terms of malpractice insurance. All practicing physicians pay in to it, although there are exemptions. The problem still is that liability is not capped at MCARE levels, so you may still need additional policies on top. All physicians are required to have a minumum of $750,000/2.25 million in basic coverage; MCARE will cover an additional $25K/$750 K on top. After that, you are responsible for paying for additional coverage (if you can find someone to write you a policy) or pay for an award out of pocket as I understand it.



It would have made more sense to place caps on payouts, etc. than have the state charge everyone a little bit so they can cover awards above the insurance policy, but that's politicians for ya...they voted it down.

 

[tripleJ]

I wonder how much the trial lawyers, who take 30-50% of the verdicts for these lawsuits, pay into this fund. Must be a lot.

 

[Winged Scapula]

I wonder how much the trial lawyers, who take 30-50% of the verdicts for these lawsuits, pay into this fund. Must be a lot.

 

[McDoctor]

http://www.pmslic.com/policyholders/mcarefund.asp

Essentially a state fund to provide increased coverage for practioners in state where the malpractice coverage and the payouts are ridiculously high.

Malpractice insurance is required in Pennsylvania (ie, you cannot go bare). However, insurance companies were not underwriting enough coverage to practice in Pennsylvania and cover the amount of the payouts the juries were awarding. So you could have malpractice insurance, but it wouldn't be enough to cover you, especially in markets like Philly. The physician then was responsible for the outlying amount...an untenable situation which caused physicians to lose their practices and which is unfriendly to the young physician starting out.

Thus, the MCARE fund was developed to help physicians in those areas where the jury awards commonly outstripped what they could purchase on the commercial market in terms of malpractice insurance. All practicing physicians pay in to it, although there are exemptions. The problem still is that liability is not capped at MCARE levels, so you may still need additional policies on top. All physicians are required to have a minumum of $750,000/2.25 million in basic coverage; MCARE will cover an additional $25K/$750 K on top. After that, you are responsible for paying for additional coverage (if you can find someone to write you a policy) or pay for an award out of pocket as I understand it.



It would have made more sense to place caps on payouts, etc. than have the state charge everyone a little bit so they can cover awards above the insurance policy, but that's politicians for ya...they voted it down.

But the insanity doesn't stop there. the MCARE Act of 2003 created a Patient Safety Authority (something like that), which is essentially a board of various retired physicians, nurses, lawyers, and other assorted political boobs, who are appointed by the governor to sit around, pontificate about patient safety, and put forth unfunded mandates to all PA hospitals.

The small community hospital I primarily work out of has hired a full time person whose sole job is to primarily make sure the hospital meets these various artificial hurdles. Things like forced changing computer log-in passwords with certain regularity, making byzantine credentialing processes even more byzantine, policing hospital abbreviations, etc...But don't worry about us, we pass the expense along to the patient.

I'm expected to complain about the law, because it means I have to write "every day" instead of "QD". But the lack of irritation by the common person whose jaw drops at the size of his bill is confusing to me.