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2007 closes with good news for physicians for 2008
Effective March 1, 2008
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PCF surcharge
to be reduced
Indiana Department of Insurance Commissioner Jim Atterholt has announced a 19.1 percent reduction in physicians’ Patient’s Compensation Fund (PCF) surcharge rate, effective March 1. The reduction for hospitals will be 1.3 percent.
“This is the first reduction for physicians and hospitals since the PCF’s inception in 1976,” Commissioner Atterholt said. He attributed the reductions to an increase in efficiencies in the administration of the PCF and to health care providers’ contributions in recent years that served to rebuild the fund’s balance, from nearly record lows just four years ago.
Doug Webber, IDOI’s chief legal counsel, pointed to recent favorable rulings from the Indiana’s courts as contributing to the decrease.
“There was movement by some plaintiffs’ attorneys to try to expand the Medical Malpractice Act’s limits by claiming one act of malpractice could generate multiple claims for emotional distress,” said Webber. “The courts of appeal have not allowed such recoveries.”
No doubt, a key to those denials by the appeals courts were the amicus briefs filed by the ISMA. “We were very pleased earlier this year when the courts agreed with the ISMA’s position in the Winkle and Butcher cases,” said Jon D. Marhenke, M.D., ISMA president.
“As the only physician organization to take action to protect the integrity of our medical malpractice statute, the ISMA has clearly demonstrated the value of membership. We’re very gratified to see physicians get financial relief.”
Stabilizing the PCF has been called essential to Gov. Daniels’ goal of ensuring the availability of affordable health care to the state’s citizens while maintaining PCF balances sufficient to compensate victims of malpractice.
Established in 1976, the PCF provides compensation to patients severely injured by medical malpractice. The fund is administered by the IDOI and funded solely through surcharge payments by Indiana health care providers.
Payouts are made from the fund twice yearly, in January and July. Following the July 2007 payout, the balance in the PCF was $122,567,120; one year prior to that the balance was only $49,964,014. Watch upcoming issues of ISMA Reports for details regarding the first 2008 payout.
Medicaid bonuses are in the mail
Bonuses totaling $26.7 million are on their way to physicians who care for the state’s Medicaid population. The payments are the result of a successful collaboration between the ISMA and the Office of Medicaid Policy and Planning.
“The bonus is being funded by money from the previous state fiscal year and is allocated to physicians based on past participation,” noted Zach Cattell, ISMA’s director of Government Relations.
Physicians can expect up to three checks if they participated in all three managed care plans, announced Jeff Wells, M.D., director of Medicaid and Health Policy.
Medicaid rate increase coming
In addition, reimbursement rates for selected evaluation and management services will increase beginning Jan. 1. It is the first time the rates have increased in 18 years.
“Legislation last year increased the cigarette tax, which helped fund the increased Medicaid rates,” explained Cattell. “Specifically, .02 cents of the .44-cent tax increase was dedicated to Medicaid physician rate increases.”
In a meeting with ISMA’s Physician Medicaid Task Force, Dr. Wells announced that Medicaid will begin utilizing a designated code for extended holiday and evening hours, which will pay $11 more in reimbursement. The specific parameters surrounding the use of this code have yet to be determined by Medicaid. Watch for details in future ISMA Reports.
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