Current through Register Vol. 46, No. 39, September 25, 2024
In order to be eligible for participation in the Medical
Malpractice Excess Insurance Program (or remain eligible if currently
participating in that program), a physician must successfully complete an
Excess Medical Malpractice Risk Management Program that meets the following
requirements:
(a) The program must
consist of at least two components:
(1) an
excess medical malpractice risk management basic course; and
(2) an excess medical malpractice risk
management follow-up course to be taken once every two years
thereafter.
(b) The
excess medical malpractice risk management basic course must:
(1) meet the requirements for Category 1
continuing medical education credit;
(2) be in either:
(i) a lecture (or other classroom setting)
format, of at least five hours in length exclusive of any breaks, covering
topics related to risk management, including but not limited to recordkeeping,
informed consent, legislation, legal environment, communication with patients,
office procedures, and critical review of case studies, at least two hours of
which shall consist of subject matter that is dedicated to topics related to
the higher potential exposure of the excess insurance risk; or
(ii) an internet-based format, requiring
interaction by the insured physician, that is equivalent to the time and
content of the lecture format described in subparagraph (i) of this
paragraph;
(3) require
the insured physician, subsequent to the lecture or internet-based course set
forth in paragraph (2) of this subdivision, to complete a project (such as the
critical review of case studies), which is designed to demonstrate and
reinforce the concepts taught in the course and which must be returned to the
insurer (or the entity conducting the risk management program) within 60 days
after completion of the basic course lecture or internet-based
course.
(c) Satisfactory
completion of both the lecture or the internet-based course, and the project is
required in order to participate in the Excess Medical Malpractice Insurance
Program.
(d) In order to remain
eligible for participation in the Excess Medical Malpractice Insurance Program
in succeeding policy years, the physician must complete an annual excess
medical malpractice follow-up course once every two years, which must:
(1)
(i)
consist of a lecture (or other classroom setting) format of at least three
hours in length exclusive of breaks. At least one hour of the course shall
consist of subject matter that is dedicated to topics related to the higher
potential exposure of the excess insurance product; or
(ii) consist of an internet-based course
format, requiring interaction by the insured physician, that is equivalent to
the time and content of the lecture format described in subparagraph (i) of
this paragraph;
(2) be
designed to reinforce the concepts covered in the excess medical malpractice
basic risk management course and to bring to the insured's attention any
relevant developments since completion of the basic course;
(3) unless provided in the excess medical
malpractice risk management basic course, contain material specific to the
insured's medical specialty; and
(4) require the insured physician, subsequent
to the lecture or the internet-based component of the course, to complete a
project (such as the critical review of case studies), which is designed to
demonstrate and reinforce the concepts taught in the course and which must be
returned to the insurer (or the entity conducting the risk management program)
within 60 days after completion of each follow-up course.
(e) If the program is presented in the
lecture format, it must contain a methodology for verifying that the insured
physician is present for the entire lecture period for both the basic and
follow-up courses, and that the required project is completed by the insured
physician in a satisfactory manner. If the program is presented in an
internet-based format, it must contain a methodology for verifying that the
insured physician has logged on, taken and completed required basic or
follow-up course and completed the required project in a satisfactory manner.
In addition, the insurer or the entity conducting the internet-based program
must require the insured physician to affirm that he or she was the person who
actually took the program and that he or she is aware that any benefit granted
pursuant to completion of the program is based on his or her
affirmation.
(f) If the program is
presented in the lecture format, it must be taught by persons with appropriate
expertise in the subject areas being covered. If the program is presented in an
internet- based format, the program must be developed by persons or entities
with appropriate technological expertise, and the program content must be
developed by persons or entities with appropriate expertise in the subject
areas covered.
(g) The program must
contain a provision whereby an insured who transfers excess medical malpractice
insurance coverage from another insurer will continue to participate in the
Excess Medical Malpractice Insurance Program, but only if the insured has
completed all requirements for such participation.
(h)
(1) The
program must be administered by the insurer or, after the insurer has
investigated the entity's qualification, by an entity designated by the insurer
to administer the program on its behalf.
(2)
(i) The
superintendent, pursuant to section 42 of part A of chapter 1 of the Laws of
2002, as amended by section 16 of part J of chapter 82 of the Laws of 2002 and
chapter 420 of the Laws of 2005, has designated the Medical Society of the
State of New York (the Medical Society) to review those portions of the basic
and follow-up courses dedicated to the excess risk of each insurer's program in
order to assure that the subject matter addresses the excess exposure and is
consistent among all insurers offering the Excess Medical Malpractice Insurance
Program.
(ii) Subject to the
approval by the superintendent, the Medical Society shall develop guidelines
for use in evaluating the courses submitted to it for review. A copy of these
guidelines shall be provided to an insurer upon request.
(iii) The Medical Society shall complete its
review and provide a determination of any course submitted to it within 30 days
of receiving all needed information. Failure to render a determination within
such period is deemed a denial.
(iv) An insurer may, within 30 days, appeal
an adverse determination by the Medical Society to the
superintendent.