Pennsylvania Code › Title 31 - INSURANCE › Part IX - Medical Catastrophe Loss Fund › Chapter 243 - MEDICAL MALPRACTICE AND HEALTH-RELATED SELF-INSURANCE PLANS › Section 243.2 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this chapter,
				  have the following meanings, unless the context clearly indicates otherwise:
Act
-The Health Care Services Malpractice Act
				  (40
				  P.S. §§
										1301.101-1301.1006).
Asserted claim
-An incident about which the
				  potential claimant has made a communication and which, after review of the
				  circumstances, leads to the reasonable conclusion that the provider may have
				  possible claim liability.
Commissioner
-The Insurance Commissioner of
				  the Commonwealth.
Department
-The Insurance Department of the
				  Commonwealth.
Effective date
-The date on which the
				  Commissioner initially approved a self-insurance plan, whether under this
				  chapter or prior regulations.
Government
-The government of the United
				  States, a state, a political subdivision of a state, an instrumentality of one
				  or more states or an agency, subdivision or department of these forms of
				  government. The term includes a corporation or other association organized by a
				  government for the execution of a government program and subject to control by
				  a government or corporation or agency established under an interstate compact
				  or international treaty.
Health care provider
-A primary health center
				  or person, corporation, facility, institution or other entity licensed or
				  approved by the Commonwealth to provide health care or professional medical
				  services as a physician, an osteopathic physician, a surgeon, a certified nurse
				  midwife, a podiatrist, hospital, nursing home, birth center and, except as to
				  section 701(a) of the act (40 P.S. §
										1301.701(a)), an officer,
				  employe or agent of any of the providers acting in the course and scope of
				  employment.
Plan of risk management
-A plan established
				  and maintained for the purpose of reducing, through loss prevention, loss
				  reduction and other generally accepted risk management techniques, the
				  frequency and severity of personal injuries arising out of the rendition of or
				  failure to render professional services by a health care provider.
Primary health center
-A community-based
				  nonprofit corporation, meeting standards prescribed by the Department of
				  Health, which provides preventative, diagnostic, therapeutic and basic
				  emergency health care by licensed practitioners who are employes of the
				  corporation or under contract to the corporation.
Professional liability insurance
-Insurance
				  against liability on the part of the health care provider arising out of a tort
				  or breach of contract causing injury or death, resulting from the furnishing of
				  medical services which were or should have been provided.
Self-insurance
-The assumption by a health
				  care provider of a professional liability risk arising out of a tort or breach
				  of contract causing injury or death resulting from the furnishing of medical
				  services which were or should have been provided.
The provisions of this §
											243.2 amended under The Insurance
					 Department Act of 1921 (40 P. S. §§
												1-321); The Insurance Company Law of 1921
					 (40
					 P. S. §§
												341-991); and sections
					 206, 506, 1501 and 1502 of The Administrative Code of 1929 (71 P. S.
					 §§
												66,
					 186,
					 411 and
					 412); and the Health Care
					 Services Malpractice Act (40 P. S. §§
												1301.101-1301.1006).