Medical Malpractice in Pennsylvania: What is MCARE?

What is MCARE?

The Medical Care Availability and Reduction of Error Fund, also known as MCARE, is a special fund within Pennsylvania’s State Treasury that was established to safeguard reasonable compensation for people who are victims of medical negligence and malpractice. It was included in by Act 13 of 2002, and signed into law on March 20, 2002. The money that is contained in the fund is used to compensate malpractice sufferers whose damages exceed the amount of coverage for which the responsible party is insured.

What is the Responsibility of the MCARE Fund?

There are three ways that the MCARE Fund is responsible for serving residents of the Commonwealth of Pennsylvania: with claims, compliance, and coverage. When a medical provider is sued for malpractice, the MCARE Fund is usually involved in handling the claims and any compensation that is made to the plaintiff. Additionally, they act as a mediator in cases that have multiple defendants. MCARE works to provide all parties involved in malpractice disputes with a means for more effective resolution of claims that are likely to settle rather than go to trial.

The MCARE Act also makes sure that doctors, health care providers, and hospitals are compliant with medical professional liability insurance requirements. The MCARE Fund is the agency responsible for collecting and monitoring the evidence regarding mandatory insurance requirements, and for reporting any noncompliance to the corresponding licensing boards for the suspension or revocation of health care providers’ licenses when necessary.

Lastly, the MCARE Fund is responsible for collecting yearly assessments of insurance coverage from all the health care providers that it serves.

What Does MCARE Require of Medical Entities?

Pennsylvania state law requires health care providers who provide 50 percent or more of their medical care within the state to maintain medical malpractice insurance coverage. That means that if a doctor of hospital conducts more than half of its business in Pennsylvania, it is mandated to participate in MCARE.

Those health care providers who are required to participate in MCARE must have two tiers of insurance coverage.

1. A primary insurance policy that they obtain in the private market
2. An additional policy through MCARE that is obtained by tendering a surcharge directly to MCARE

Doctors and surgeons are required to maintain limits of $1,000,000 per claim. Their private primary insurance policy must cover $500,000 of any claim, while the MCARE Fund will cover anything over that for losses, up to another $500,000.

When a provider is required to participate in MCARE and a malpractice suit is filed against them, if they believe that the plaintiff will be awarded damages that are greater than their primary insurance covers, they are required to notify MCARE promptly, in writing, of the details of the claim.

There are exceptions as to which health care providers are required to participate in MCARE. For example, providers who are employed exclusively with the Federal government are exempt.

How Does MCARE Work for the Patient?

Generally speaking, if an injured patient is awarded damages in a malpractice case, then the MCARE Fund will be used to cover the part of the awarded damages that exceed the coverage of the provider’s primary insurance policy.

Here is an example of how an injured patient might be compensated for a medical malpractice lawsuit in Pennsylvania:

1. The first requirement is that the medical provider has tendered his or her $500,000 to the MCARE Fund. It is only after providers tender that MCARE offers excess coverage of an additional $500,000.
2. The injured patient sues the doctor and hospital and is awarded damages of $2,000,000, but the doctor and the hospital are each only insured by their primary insurance for $500,000, totaling $1,000,000 in insurance coverage.
3. Because the amount awarded to the injured patient is over the amount that the doctor and hospital are insured for, MCARE kicks in an additional layer of monies - $500,000 for the doctor and $500,000 for the hospital.
4. The patient collects the total amount of the $2,000,000 award.

This, of course, is a simplified example. Medical malpractice cases are typically much more complicated and should be handled by an experienced malpractice attorney for the best financial outcome for injured parties.

If You Are a Victim of Medical Malpractice

If you or your loved one has been injured due to medical malpractice in Pennsylvania, it’s important that you seek the guidance of an attorney who is knowledgeable about Pennsylvania malpractice law, including the MCARE Fund.

At Ross Feller Casey, we have attorneys on staff to help you determine how to proceed with your case. Contact us today for a free consultation and case review. If you have a lawsuit, we can represent your interests in your case. All of our medical malpractice cases are handled a contingency basis, so you won’t pay unless there is a financial award in your favor.