Last Updated: Nov 4, 2020
The Pennsylvania Insurance Department announced that the annual assessment for basic insurance coverage insurers and self-insured participating health care providers to be levied for calendar year 2021 is 19% applied to the prevailing primary premium for each participating health care provider.
Under Mcare, the Insurance Department is required annually to set the Mcare assessment. The Mcare assessment is a percentage of the Pennsylvania Professional Liability Joint Underwriting Association (JUA) rates as approved by the Pennsylvania Insurance Department. For 2021, the assessment rate is 19%. This rate has remained at 19% since 2017.
If a health care provider (which includes physicians) is licensed in Pennsylvania and 50% or more of the patients to whom the provider renders healthcare services are in Pennsylvania, participation in Mcare is mandatory. If a provider is licensed in Pennsylvania and less than 50% but more than 0% of patients to whom the provide renders healthcare services are in Pennsylvania, the provider may choose to participate in Mcare. However, if the provider opts out of participating in Mcare, the provider must still meet the mandatory insurance requirements of Act 13 of 2002.
A copy of the notice can be accessed here.
PAMED’s Legal Resource Center offers a wide variety of member-only resources that address health-law related questions on topics like Mcare, Pennsylvania health care regulations, and much more. Get details at www.pamedsoc.org/LegalResourceCenter.