N.J. Admin. Code § 13:35-6.18

Current through Register Vol. 56, No. 21, November 4, 2024

Section 13:35-6.18 - Medical malpractice coverage; letter of credit

(a) The following words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise.

"Authorized" means recognized by a governmental agency to offer medical malpractice insurance products.

"Covered" means ongoing maintenance of insurance in the sum of $ 1 million per occurrence and $ 3 million dollars per policy year, with extended reporting endorsement coverage for claims made ("tail coverage") issued by a carrier or other entity authorized to write medical malpractice policies.

"Letter of credit" means a non-assignable, non-transferable, unexpired, continuous irrevocable obligation, liability bond or other instrument issued by a bank or saving association authorized to do business in this State, payable to the physician or podiatrist as the beneficiary within 30 days after a demand for payment and the presentation of a final judgment or settlement in a medical malpractice action.

"Maintaining a professional practice with responsibility for patient care" means the furnishing of professional services to patients in New Jersey, including, but not limited to, the testing for, or diagnosis of, or the offering or furnishing of treatment, preventative medical care or consultation relating to human disease or dysfunction or physical condition, including the prescribing, administering or dispensing of products, devices or drugs at a place, such as an office (even if located in a home), hospital or clinic, or through a business entity, such as a laboratory or mobile van service.

"Not available" means that a physician or podiatrist is unable to purchase medical malpractice insurance coverage from a carrier authorized to write medical malpractice insurance, including through programs relating to risk retention groups deemed eligible by the Department of Banking and Insurance, surplus lines registered with the Department of Banking and Insurance, self-insurance trusts or captive insurance companies approved by the New Jersey Health Care Facilities Financing Authority in the Department of Health and Senior Services. "Not available" for purposes of this section does not mean "not affordable."

(b) All physicians and podiatrists licensed to practice in this State who maintain a professional practice and have responsibility for patient care shall be covered by medical malpractice insurance or, if medical malpractice insurance is not available, shall secure and maintain a letter of credit at least in the sum of $ 500,000 or more.

(c) For purposes of this section, physicians or podiatrists when practicing as employees of the Federal, State or county government or physicians practicing pursuant to an exemption from the prohibitions of the Medical Practice Act set forth at 45:9-21 will not be deemed to be maintaining a professional practice.

(d) Physicians and podiatrists who are not covered by medical malpractice insurance shall present to the Board a true copy of the letter of credit required pursuant to (b) above and shall notify the Board, within seven days, whenever:

1. A demand for payment on the letter has been made;

2. The continuing viability of the letter has been affected, for whatever reason; or

3. There has been a change in status affecting whether the physician or podiatrist is or continues to be exempt from the requirement.

(e) Violations of (b) and (d) above shall be deemed professional misconduct within the meaning of 45:1-21(e).

N.J. Admin. Code § 13:35-6.18

New Rule, R.1993 d.604, effective 12/6/1993.
See: 24 N.J.R. 4012(a), 25 N.J.R. 5487(a).
Repealed by R.1997 d.475, effective 11/3/1997.
See: 29 N.J.R. 842(a), 29 N.J.R. 4706(a).
Section was "Prescribing, dispensing or administering anabolic steroids".
New Rule, R.1999 d.117, effective 4/5/1999.
See: 30 N.J.R. 4318(a), 31 N.J.R. 881(a).
Petition for Rulemaking.
See: 35 N.J.R. 3418(a), 3967(c).
Petition for Rulemaking.
See: 36 N.J.R. 588(a).
Public Notice: Conference for Solicitation of Informal Public Input on Medical Malpractice Coverage Requirements.
See: 36 N.J.R. 1134(a).
Petition for Rulemaking.
See: 36 N.J.R. 4180(a).
Amended by R.2005 d.120, effective 4/18/2005.
See: 36 N.J.R. 4633(a), 37 N.J.R. 1203(a).
In (a), added "Authorized, inserted "or other entity" following "issued by a carrier" in "Covered", inserted ", liability bond or other instrument" following "irrevocable obligation" in "Letter of credit", and rewrote "Not available".