Patient's Compensation Fund - Surcharge Rates for Hospitals and Physicians

December 16, 2011 Bulletin 186 PATIENT'S COMPENSATION FUND­ SURCHARGE RATES FOR HOSPITALS AND PHYSICIANS This bulletin is directed to all health care providers electing to be qualified under Indiana's Medical Malpractice Act (IC 34-18-1-1 et seq.) and to insurers that provide coverage to those health care providers. Pursuant to IC 34-18-5-2, the Commissioner of the Department oflnsurance in his capacity as administrator of the Patient's Compensation Fund ("PCF") hereby notifies physicians and hospitals of the following surcharge for qualification under the Medical Malpractice Act. The rates are effective for coverage beginning March 1, 2012. PHYSICIANS The surcharge for physicians will decrease by 10.2% from the rates effective March 1, 2011 through February 29, 2012. A complete list of physician specialty class codes is published at 760 IAC 1-60-3. CLASS ANNUAL RATE 0 $1,783 1 $2,377 2 $3,328 3 $4,279 4 $5,348 5 $7,131 6 $10,697 7 $16,639 8 $20,205 HOSPITALS The surcharge for a hospital is calculated using the attached worksheet. The completed worksheet shall be submitted to the Department along with the surcharge payment. The attached worksheet reflects an overall 1.7% decrease in surcharge for hospitals. INDIANA DEPAR.TMENT OKSURAN.C.E -­ ' c-. ~ ) ~ :jj ~ u_;. ~-"-­ Steph=w. Robertson, Insurance Commissioner HOSPITAL EXPOSURE WORKSHEET FOR SURCHARGE CALCULATION Name of Hospital: _______________________ License No: Attach a list of the following: (1) All facilities and/or services operated under the hospital license, as identified on the Department of Health Application for License to Operate a Hospital; (2) All assumed business names used by the hospital; (3) All employed physicians included in this coverage along with their specialty class code and surcharge computation; Any entity, person or activity not identified in this surcharge worksheet may not be included in the hospital's coverage with the PCF. CATEGORY EXPOSURE MANUAL TOTAL Provide # of Beds Category x Manual=Total Hospital (Acute care and Intensive Care) $589 Mental Health/Rehabilitation $295 Extended Care/Intermediate Care/Residential $29 Nursing Home/Critical Extended Care $295 Health Institution/Assisted Living/Other $118 Bassinets $589 # of Visits (in 100s) Emergency Room $58.90 Clinics/Others $29.45 Mental Health/Rehabilitation $14. 73 Health Institution $11. 78 Home Health Care $29.45 Provide# of Surgeries/Births (in 100s) Births $2,356 Outpatient Surgeries $58.90 Inpatient Surgeries $1,178 Employed* Physicians Sharing Limits 100% of Specialty Code SUB­ TOTAL Lack of Risk Management Program 10% Penalty x sub-total Hospital with > 500 beds 3% multiplier of subtotal TOTAL DUE Definitions: Hospital bed - Licensed hospital beds usually on a short term basis for patients who need acute medical treatment and skilled nursing care 24 hours a day (intensive diagnostic and invasive treatment for acute illness). Mental Health/Mental and Physical Acute Rehab bed - Care, diagnosis, and treatment for acute psychiatric, emotionally challenged, and physically handicapped patients needing 24 hour supervision, assistance and treatment. Extended Care/Intermediate/Residential bed - Non-acute occasional incidental medical and emergency assistance to residents living independently in retirement apartments and communities. Facilities provided with security and emergency call boxes. Some contact services are available to residents. Nursing Home/Critical Extended Care bed - A step-down from acute medical care for patients still needing 24 hour nursing care usually for an extended or long term basis. Skilled care services needed, such as medication administration, tube feeding, injections, catheterizations, and other procedures ordered by a physician. Health Institution/Assisted Living/Other bed - Sub-acute minor health care and related personal services to assist residents on an ongoing and regular basis. Minor nursing care and assistance in such activities as laundry, meal preparation, bathing, and social functions. * Employed physician - A physician is considered an employee for PCF purposes if the hospital withholds and pays Social Security and Medicare taxes and pays unemployment tax on wages paid to the employee. If a physician is treated as an independent contractor for tax purposes then he/she cannot be considered an employee for PCF purposes.