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S.F. No. 1011 |
Medical malpractice insurance account-2. |
Sponsored By: Joint Appropriations Interim Committee
AN ACT relating to medical malpractice premiums; creating the medical malpractice insurance assistance account; authorizing assistance for payment of physicians' medical malpractice insurance premiums as specified; providing requirements; specifying duties; providing an appropriation; and providing for an effective date.
7/09/2004 Bill Number Assigned
7/12/2004 S Received for Introduction
7/12/2004 S Introduced and Referred to SCW
7/12/2004 S Placed on General File
SF1011SW001/FAILED (CORRECTED COPY)
Page 1-line 5 After "duties;" insert "authorizing the insurance department to sell prior acts medical malpractice insurance as specified;
Page 3-line 4 Delete "and".
Page 3-line 8 Delete "." insert "; and".
Page 3-after line 8 Insert:
"(viii) With regard to the prior acts coverage provided pursuant to W.S. 35-1-903, there is a chance the state will make a profit and a chance it will have a loss and the relative likelihood of these two (2) outcomes is unknown at the time this legislation was considered and passed.".
Page 3-line 21 Delete "and 35-1-902" insert "through 35‑1‑903".
Page 9-before line 23 Insert and renumber:
"35-1-903. Prior acts insurance coverage.
(a) The department shall sell prior acts medical malpractice insurance to any physician who:
(i) Is licensed and practicing in the state;
(ii) Is seeking to purchase prior acts coverage and is unable to purchase the coverage from an admitted carrier with a rating of B- or better from AM Best Company; and
(iii) Agrees to the provisions set forth in W.S. 35‑1‑902(d)(i) through (iii).
(b) The department shall establish a price for the prior acts coverage subject to the following:
(i) The price shall be at least one hundred fifty percent (150%) of the highest base rate for the relevant specialty or risk case in effect January 1, 2004 for an admitted carrier with at least a twenty percent (20%) market share of the total medical malpractice market in Wyoming. It shall be the duty of the commissioner to advise the department of these rates;
(ii) The department may charge an individual up to fifty percent (50%) more than the minimum premium established in subparagraph (i) of this subsection based on individual risk factors or changes in market conditions.
(c) The department shall, with the advice of the commissioner, establish policy forms and contracts for coverage provided by this section which comply with this act and are as consistent as practical with normal good industry practices.
(d) Premiums received from physicians for coverage under this section shall be deposited in the account, and any losses and costs for administration, loss adjustment, legal representation and legal defense shall be paid from the account.
(e) The department shall sell secondary medical malpractice coverage for prior acts to any physician who:
(i) Is licensed and practicing in the state;
(ii) Has a prior acts policy from an admitted carrier which carrier is insolvent or is rated at B- or worse by AM Best Company;
(iii) Agrees to the provisions set forth in W.S. 35-1-902(d)(i) through (iii).
(f) The department shall price the coverage authorized by subsection (c) of this section subject to the following:
(i) The maximum price shall be the price established pursuant to subsection (b) of this section and the minimum price shall be twenty percent (20%) of that price;
(ii) The price shall reflect the risk that the coverage will be used considering:
(A) The length of time the primary coverage has been in effect;
(B) The risk the primary carrier will become insolvent and the timing of that risk.
(iii) It shall be the duty of the commissioner to advise the department of the risks to be considered pursuant to paragraph (ii) of this subsection.
(g) For coverage provided by this section, the department shall allow regular participation in a clinic providing free or reduced priced coverage to poor people to be substituted for the requirement to treat under the Wyoming Medical Assistance and Services Act or the child health insurance program established by W.S. 35-1-102(d)(ii).
(h) No coverage shall be provided under this section unless the physician has completed and submitted an application to the department on or before June 30, 2005.". SCOTT
SF1011SW002/ADOPTED
Page 9-After line 21 Insert:
"(j) No loan shall be made under this section unless the insurance procured to meet the requirements of subparagraph (c)(ii)(A) or (B) of this section is procured from an insurer with an AM Best financial strength rating of not less than "B-".". BARRASSO
7/13/2004 S Passed CoW
SF1011S2002/ADOPTED
Delete the Barrasso Committee of the Whole Amendment (SF1011SW002/A) entirely. CASE
SF1011S2003/FAILED
Page 3-line 21 Delete "and 35-1-902" insert "through 35-1-903".
Page 9-line 22 Insert and renumber:
"35-1-903. Assistance for malpractice insurance premiums; duties of the department; requirements for assistance; breach.
(a) Any physician who is licensed and practicing in the state may apply to the department for assistance in paying a portion of the physician's medical malpractice insurance premiums as provided in this section. Upon approval of the application for assistance, the physician shall enter into a contract with the state, wherein the physician shall agree:
(i) To practice in the area of medical specialty or subspecialty for the entire period of the contract for which malpractice insurance premium assistance is to be provided under this section;
(ii) To provide medical care for the entire period of the contract to Wyoming residents qualified under the Wyoming Medical Assistance and Services Act or the Child Health Insurance Program established under W.S. 35‑25‑101 who are seeking medical care which the physician is qualified to provide;
(iii) To submit documentation to establish that the physician has complied with the terms of the contract and to determine the amount of assistance that should be provided; and
(iv) To repay all funds distributed to the physician pursuant to this article, together with attorney fees and costs incurred in collection, for any contract period in which the physician is in breach of the contract.
(b) At the times specified in the contract but in no event less than once per year, the physician shall submit documentation to the department showing compliance with the terms of the contract. The department shall examine the documentation provided by the physician and calculate the amount of assistance if any to be provided. The amount of assistance to be provided shall be calculated by:
(i) Determining the amount of medical malpractice insurance premiums paid by the physician;
(ii) Determining the percentage of the physician's practice dedicated to providing the care to the persons specified in paragraph (a)(ii) of this section. This determination shall be based upon the dollar amount of billings made;
(iii) Multiplying the percentage determined under paragraph (ii) of this subsection by the amount determined under paragraph (i) of this subsection; and
(iv) Multiplying the product obtained in paragraph (iii) of this subsection by one-half (1/2).
(c) If funding available from the account is insufficient to pay assistance for all physicians who apply for assistance under this section, the department may at its discretion reduce the payments to pay each eligible physician a pro rata amount.
(d) A physician who receives assistance for medical malpractice insurance under this section may, upon full reimbursement to the medical malpractice insurance premium account for the assistance received in a contract period, cancel the contract at any time.
(e) In addition to any other civil or criminal penalties that may be imposed by law, any physician who fails or refuses to fulfill the terms of the contract required under subsection (a) of this section shall be in breach of the contract. The department may obtain the assistance of the attorney general to recoup the amount of assistance provided under the contract together with attorney fees and other costs of collection.
(f) The payment amounts and the name of a physician receiving payments under this section shall be a public record. Any other information used by the department in determining the amount of payment to physicians, including all information submitted to the department by a physician under this article, which is not already matters of public record is confidential and is not a public record under W.S. 16-4-201 through 16-4-205.
(g) This section is repealed effective June 30, 2007.".
Page 10-line 1 Delete "eight million two".
Page 10-line 2 Delete through "($8,200,000.00)" insert "eighteen million two hundred thousand dollars ($18,200,000.00)".
Page 10-line 3 After "loans" insert "and assistance". MOCKLER
ROLL CALL
Ayes: Senator(s) Barrasso, Boggs, Caller, Decaria, Ginter, Goodenough, Job, Massie, Mockler, Sessions and Vasey.
Nays: Senator(s) Anderson, J., Burns, Case, Coe, Devin, Erb, Geis, Hanes, Hawks, Hines, Kunz, Larson, Meier, Northrup, Peck, Roberts, Schiffer, Scott and Townsend.
Ayes 11 Nays 19 Excused 0 Absent 0 Conflicts 0
SF1011S2004/ADOPTED
Delete the Meier Second Reading Amendment (SF1011S2001/A) entirely and further amend as follows:
Page 8-line 3 Delete "of two percent".
Page 8-line 4 Delete "(2%)" insert "equal to that charged for federal Stafford loans on the date on which the loan proceeds are disbursed". MASSIE
SF1011S2005/ADOPTED
Delete the Meier Second Reading Amendment (SF1011S2001/A) and the Massie Second Reading Amendment (SF1011S2004/A) entirely and further amend as follows:
Page 8-line 3 Delete "of two percent".
Page 8-line 4 Delete "(2%)" insert "as determined by the state treasurer at an annual rate equal to the average prime interest rate during the preceding fiscal year plus one percent (1%). To determine the average prime interest rate, the state treasurer shall average the prime interest rate for at least seventy-five percent (75%) of the thirty (30) largest banks in the United States. The interest rate shall be adjusted on January 1 of each year". CASE, DECARIA
ROLL CALL
Ayes: Senator(s) Anderson, J., Barrasso, Burns, Case, Coe, Decaria, Erb, Geis, Hanes, Hawks, Kunz, Larson, Meier, Northrup, Roberts, Scott, Townsend and Vasey.
Nays: Senator(s) Boggs, Caller, Devin, Ginter, Goodenough, Hines, Job, Massie, Mockler, Peck, Schiffer and Sessions.
Ayes 18 Nays 12 Excused 0 Absent 0 Conflicts 0
7/14/2004 S Passed 2nd Reading
SF1011S3001/ADOPTED CORRECTED COPY
Page 1-line 4 After ";" insert "providing for state loans to physicians for participation in risk retention groups as specified; providing for repayment;".
Page 3-line 21 Delete "and 35-1-902" insert "through 35-1-903".
Page 5-line 12 Delete "section" insert "article".
Page 5-line 15 Delete "section" insert "article".
Page 8-line 7 Delete "article" insert "section".
Page 9-After line 21 Insert and renumber:
"35-1-903. Assistance for risk retention group participation; duties of the department; requirements for assistance; breach.
(a) Any physician who is licensed and practicing in the state may apply to the department for a loan to be used to pay the cost of the physician's participation in a risk retention group, of which the majority of ownership interest is held by Wyoming physicians, providing medical malpractice insurance coverage. Upon approval of the application for a loan, the physician shall enter into a contract with the state, wherein the physician shall agree:
(i) To practice in the area of medical specialty or subspecialty for the entire period of time for which the loan under this section remains unpaid;
(ii) To provide medical care, for the entire period of time the loan under this section remains unpaid, to Wyoming residents qualified under the Wyoming Medical Assistance and Services Act or the Child Health Insurance Program established under W.S. 35‑25‑101 who are seeking medical care which the physician is qualified to provide;
(iii) To submit documentation to establish that the physician has complied with the terms of the contract and to determine the amount of the loan that should be provided under this section;
(iv) To provide the state with a security interest in the physician's membership or shareholder interest in the risk retention group;
(v) To repay any loans made under this section within ten (10) years from the date of disbursement of loan proceeds, together with interest as determined by the state treasurer at an annual rate equal to the average prime interest rate during the preceding fiscal year plus one percent (1%). To determine the average prime interest rate, the state treasurer shall average the prime interest rate for at least seventy-five percent (75%) of the thirty (30) largest banks in the United States. The interest rate shall be adjust on January 1 of each year; and
(vi) To immediately repay all funds distributed to the physician pursuant to this section, together with attorney fees and costs incurred in collection, for any contract period in which the physician is in breach of the contract.
(b) At the times specified in the contract but in no event less than once per year, the physician shall submit documentation to the department showing compliance with the terms of the contract. The amount of loan to be made shall be the amount applied for but not to exceed one hundred fifty percent (150%) of the physician's most recent annual malpractice insurance premium. The department may approve the making of the loan upon its determination of compliance with this section. Loan proceeds shall not be disbursed until the physician has paid or immediately will pay for his participation in the risk retention group.
(c) If funding available from the account is insufficient to pay assistance for all physicians who apply for assistance under this article, the department may at its discretion reduce the payments to pay each eligible physician a pro rata amount.
(d) Any physician who fails or refuses to fulfill the terms of the contract required under subsection (a) of this section shall be in breach of the contract. Loans under this section shall be subject to the provisions of W.S. 35-1-902(f) and (g).
(e) No loan shall be made under this section unless the physician has completed and submitted an application to the department on or before January 15, 2005.".
Page 10-line 1 Delete "eight million two".
Page 10-line 2 Delete through "($8,200,000.00)" insert "thirteen million two hundred thousand dollars ($13,200,000.00)".
Page 10-line 4 After "premiums" insert ", loans for risk retention group participation". DEVIN, COE
ROLL CALL
Ayes: Senator(s) Anderson, J., Barrasso, Boggs, Burns, Caller, Coe, Devin, Erb, Geis, Ginter, Hanes, Hawks, Kunz, Larson, Massie, Meier, Northrup, Peck, Sessions and Vasey.
Nays: Senator(s) Case, Decaria, Goodenough, Hines, Job, Mockler, Roberts, Schiffer, Scott and Townsend.
Ayes 20 Nays 10 Excused 0 Absent 0 Conflicts 0
7/15/2004 S Passed 3rd Reading
ROLL CALL
Ayes: Senator(s) Anderson, J., Barrasso, Boggs, Caller, Coe, Devin, Erb, Geis, Ginter, Hanes, Hawks, Hines, Kunz, Meier, Northrup, Peck and Vasey.
Nays: Senator(s) Burns, Case, Decaria, Goodenough, Job, Larson, Massie, Mockler, Roberts, Schiffer, Scott, Sessions and Townsend.
Ayes 17 Nays 13 Excused 0 Absent 0 Conflicts 0
7/15/2004 H Received for Introduction
7/15/2004 H Introduced and Referred to H12
7/15/2004 H12 Recommended Place on 3rd Reading
ROLL CALL
Ayes: Representative(s) Anderson, R., Illoway, Johnson, L., Johnson, W., Luthi, Nicholas, Parady, Philp, Ross and Thompson.
Nays: Representative(s) Baker.
Excused: Representative(s) Reese and Simpson.
Ayes 10 Nays 1 Excused 2 Absent 0 Conflicts 0
7/15/2004 H Placed on 3rd Reading
7/15/2004 S Appointed JCC01 Members
Devin, Schiffer, Coe, Job, Larson
7/15/2004 H Appointed JCC01 Members
Cooper, Brechtel, Gilmore, Harshman, Petersen
7/16/2004 S Adopted SF1011JC01
ROLL CALL
Ayes: Senator(s) Anderson, J., Barrasso, Boggs, Burns, Caller, Coe, Decaria, Devin, Erb, Ginter, Goodenough, Hanes, Hawks, Hines, Kunz, Larson, Massie, Meier, Northrup, Peck, Roberts, Schiffer, Sessions, Townsend and Vasey.
Nays: Senator(s) Case, Job, Mockler and Scott.
Excused: Senator(s) Geis.
Ayes 25 Nays 4 Excused 1 Absent 0 Conflict 0
7/16/2004 H Adopted SF1011JC01
ROLL CALL
Ayes: Representative(s) Alden, Allen, Anderson, R., Bagby, Baker, Berger, Brechtel, Buchanan, Bucholz, Childers, Cohee, Cooper, Diercks, Edwards, Esquibel, Gentile, Gilmore, Harshman, Harvey, Hinckley, Iekel, Illoway, Jansen, Johnson, L., Johnson, W., Jones, Jorgensen, Landon, Latta, Law, Lockhart, Luthi, Martin, McMurtrey, McOmie, Meuli, Meyer, Miller, D., Morgan, Nicholas, Olsen, Osborn, Parady, Petersen, Philp, Powers, Prosser, Reese, Robinson, Ross, Semlek, Simpson, Slater, Thompson, Walsh, Warren, Wasserburger and Wostenberg.
Excused: Representative(s) Hageman and Hastert.
Ayes 58 Nays 0 Excused 2 Absent 0 Conflicts 0
SF1011JC01/AA ADOPTED
Adopt the following House amendments:
HB1011H2001/A
Delete the following House amendments:
HB1011H2002/A
HB1011HW001/A
Adopt the following Senate amendments:
SF1011S2005/A
Delete the following Senate amendments:
SF1011SW002/A
SF1011S2002/A
SF1011S2004/A
SF1011S3001/A
Further amend as follows:
Page 1-line 4 After ";" insert "providing for state loans to physicians for participation in risk retention groups as specified; providing for repayment;".
Page 3-line 21 Delete "and 35-1-902" insert "through 35-1-903".
Page 4-After line 13 Insert:
"(iii) "Contracting entity" means an entity which contracts with a Wyoming licensed health care facility to provide physician services to the facility and which in fulfillment of such a contract procures medical malpractice insurance for physicians providing the contracted services;".
Page 5-line 12 Delete "section" insert "article".
Page 5-line 15 Delete "section" insert "article".
Page 8-line 7 Delete "article" insert "section".
Page 8-After line 10 Insert:
"(e) Any contracting entity shall be eligible to receive a loan under this section to the same extent as an individual physician. The contracting entity shall be required to establish that for the physicians whose services the entity provides, the entity has procured insurance which meets the requirements specified in subsection (c) of this section. The contracting entity shall be further required to contract with the state agreeing to meet the requirements of paragraphs (d)(iii) through (v) of this section, with the entity agreeing to meet the requirements imposed upon individual physicians. The contracting entity shall also agree that each physician providing services within Wyoming who is within its contracting group shall meet the provision of service requirements of paragraphs (d)(i) and (ii) of this section, with the duration being modified to a period of the lesser of the time the physician is a member of the contracting entity's group or three (3) years.".
Page 8-line 13 After "physician" insert "or the contracting entity receiving a loan under this section".
Page 8-line 17 After "purchased" insert "by the individual physician or the contracting entity".
Page 8-line 21 After "physician" insert "or contracting entity".
Page 9-line 2 After "physician" insert "or contracting entity".
Page 9-line 10 After "physician" insert "or contracting entity".
Page 9-line 13 After "physicians" insert "or contracting entities".
Page 9-line 14 After "physician" insert "or contracting entity".
Page 9-line 20 After "physician" insert "or contracting entity".
Page 9-After line 21 Insert and renumber:
"35-1-903. Assistance for risk retention group participation; duties of the department; requirements for assistance; breach.
(a) Any physician who is licensed and practicing in the state may apply to the department for a loan to be used to pay the cost of the physician's participation in a risk retention group, of which the majority of ownership interest is held by Wyoming physicians, providing medical malpractice insurance coverage. Upon approval of the application for a loan, the physician shall enter into a contract with the state, wherein the physician shall agree:
(i) To practice in the area of medical specialty or subspecialty for the entire period of time for which the loan under this section remains unpaid;
(ii) To provide medical care, for the entire period of time the loan under this section remains unpaid, to Wyoming residents qualified under the Wyoming Medical Assistance and Services Act or the Child Health Insurance Program established under W.S. 35‑25‑101 who are seeking medical care which the physician is qualified to provide;
(iii) To submit documentation to establish that the physician has complied with the terms of the contract and to determine the amount of the loan that should be provided under this section;
(iv) To provide the state with a security interest in the physician's membership or shareholder interest in the risk retention group;
(v) To repay any loans made under this section within ten (10) years from the date of disbursement of loan proceeds, together with interest as determined by the state treasurer at an annual rate equal to the average prime interest rate during the preceding fiscal year plus one percent (1%). To determine the average prime interest rate, the state treasurer shall average the prime interest rate for at least seventy-five percent (75%) of the thirty (30) largest banks in the United States. The interest rate shall be adjusted on January 1 of each year; and
(vi) To immediately repay all funds distributed to the physician pursuant to this section, together with attorney fees and costs incurred in collection, for any contract period in which the physician is in breach of the contract.
(b) At the times specified in the contract but in no event less than once per year, the physician shall submit documentation to the department showing compliance with the terms of the contract. The amount of loan to be made shall be the amount applied for but not to exceed one hundred fifty percent (150%) of the physician's most recent annual malpractice insurance premium. The amount shall also be prorated for the percentage of the physician's actual practice in Wyoming. The department may approve the making of the loan upon its determination of compliance with this section. Loan proceeds shall not be disbursed until the physician has paid or immediately will pay for his participation in the risk retention group.
(c) If funding available from the account is insufficient to pay assistance for all physicians who apply for assistance under this article, the department may at its discretion reduce the payments to pay each eligible physician a pro rata amount.
(d) Any physician who fails or refuses to fulfill the terms of the contract required under subsection (a) of this section shall be in breach of the contract. Loans under this section shall be subject to the provisions of W.S. 35-1-902(g) and (h).
(e) No loan shall be made under this section unless the physician has completed and submitted an application to the department on or before January 15, 2005.".
Page 10-line 1 Delete "eight million two".
Page 10-line 2 Delete through "($8,200,000.00)" insert "thirteen million two hundred thousand dollars ($13,200,000.00)".
Page 10-line 4 After "premiums" insert ", loans for risk retention group participation".
Renumber as necessary. DEVIN, COE, JOB, LARSON, SCHIFFER, COOPER, BRECHTEL, GILMORE, HARSHMAN, PETERSEN
7/16/2004 Assigned Number SEA No. 0003
7/17/2004 S President Signed SEA No. 0003
7/17/2004 H Speaker Signed SEA No. 0003
7/29/2004 Governor Signed SEA No. 0003
Chapter No. 0005 Special Session Laws of Wyoming 2004