Understanding The Pennsylvania Medical Care Availability & Reduction Of Error Fund (“Mcare”) Act

The Pennsylvania Medical Care Availability and Reduction of Error Fund (Mcare) became law in 2002. Mcare replaced a program known as the Medical Liability Catastrophe Loss Fund (CAT Fund), which was part of the Health Care Services Malpractice Act established in 1975.

Mcare required that healthcare providers and entities licensed as hospitals maintain a minimum of $500,000 in insurance provided by primary professional liability insurers. The Mcare fund seeks to provide practical compensation for victims of medical negligence. Mcare funds are used for paying claim awards to plaintiffs against healthcare providers which exceed the $500,000 insurance threshold. The Act defines a health care provider as a person, center, corporation, university, or institution which provides medically-related services. This encompasses physicians, nurse midwifes, podiatrists, nursing facilities and others.

Beginning in 2002, all medical providers who conduct 50% or more of their business in Pennsylvania must have $500,000 in liability coverage per incident and $1,500,000 per annual aggregate. For hospitals, these minimums increase to $700,000 per incident and $2,100,000 in annual aggregate. The Act accounts for periodic increases in the minimum insurance requirements.

When a patient brings a civil action against a Mcare medical provider, the Mcare Fund will usually play a role in the claims process. Mcare may act as a mediator that possesses a comprehensive standpoint to the actions. Mcare serves as an unbiased and efficient platform for alternative dispute to equitably resolve and settle matters. The program seeks to maintain efforts to decrease medically-related errors by recognizing problems and creating potential solutions for overall patient well-being.

The Mcare Act enforces compliance among health providers for maintaining liability insurance. This state-based authority closely monitors and reports on the requirement. If a health care provider is determined to be incompliant, the Fund will execute their duty to report them to their licensing board for suspension or cancellation of their license–per state statute.

Mcare is not funded with taxpayer dollars; rather, it is supported by the healthcare providers that it works with. The Act collects assessments from providers annually. Providers who obtain their coverage through the private insurance market pay these insurers directly, and those organizations transmit the annual assessment to Mcare. Those providers who choose to self-insure, provide their assessments to Mcare directly.

Pennsylvania has a two-year statute of limitations in matters of medical malpractice. The two-year period begins from the time that the alleged act of malpractice occurred. Often the patient is unaware of the negligent act for a period of time. A discovery rule exists, which essentially halts or stalls the two year period, having the period begin from the date the patient uncovers the error. An example of an exception to these limitations is when the case is based on a surgery where an unintended object was left within the patient’s body.