Opinion ID: 2319313
Heading Depth: 1
Heading Rank: 4

Heading: Required Annual Surcharge of Section 1301.701(e)(1). [7]

Text: Even if one were to argue that nurses generally could participate in the CAT Fund, I would still conclude that Nurse DiRienzo is not entitled to CAT Fund coverage separate and distinct from that of her employer. As previously stated, there exist two prerequisites to CAT Fund coverage: 1) the basic coverage insurance; and 2) payment of an annual surcharge. All health care providers entitled to participate in the Fund must pay an annual surcharge or have the annual surcharge paid on their behalf by the professional liability carrier providing primary coverage. 40 Pa.C.S.A. §§ 1301.701(e)(1) and (f); 31 Pa.Code § 242.17(b). This annual surcharge, a percentage of a health care provider's annual insurance premium, finances the Fund. 40 Pa.C.S.A. § 1301.701(e)(1). Only those who contribute may claim entitlement to CAT Fund disbursements. 31 Pa.Code § 242.17(b). Nowhere does the record reveal that Nurse DiRienzo paid the annual surcharge or that the annual surcharge was paid on her behalf. In fact, the record indicates that no such surcharge was ever paid. A participating health care provider need not file any documents with the CAT Fund. Such a health care provider's primary insurance carrier . . . is required to file with the Fund on behalf of the health care provider the following: 1) Form 216  `Remittance Advice,' or 2) Form 5116  `Acknowledgement of insurance and surcharge.' Answers and Objection of CAT Fund to Interrogatories of American Casualty, 3 (May 8, 1991) (attached as exhibit A to American Casualty's Motion to Compel). Form 216  Remittance Advice  is to be used. . . for summarizing surcharges collected, payable and refundable. 31 Pa.Code § 242.6(a)(3). Form 5116  Acknowledgement of Insurance and Surcharge Paid  is intended to acknowledge that the health care provider has purchased basic coverage professional liability insurance and paid the Fund surcharge. Id. at (a)(1). In an affidavit, Kenneth Butler, the supervisor of the Financial Audit Unit of the CAT Fund, stated that, after reviewing the Fund's records regarding the calculation and payment of surcharge amounts on behalf of health care providers, 1) the Fund had no record of coverage for Nurse Sharon DiRienzo as a health care provider for the year 1988; 2) the Fund had no record of a surcharge payment on behalf of Sharon DiRienzo referable to the year 1988; and 3) the Remittance Advice filed with the Fund by Sharon DiRienzo's employer, Bryn Mawr Hospital, for the year 1988 does not indicate that Nurse Sharon DiRienzo is a health care provider entitled to coverage. Affidavit of Kenneth Butler, 2 (June 12, 1991) (attached as exhibit C to exhibit C of American Casualty's Motion to Compel). In its Response to the CAT Fund's Request for Admissions, American Casualty admitted that it did not collect or submit to the Pennsylvania Medical Professional Liability Catastrophe Loss Fund any surcharge amount as a result of or in connection with its issuance of Policy No. NS03807436 [the Professional Nurse's Liability Policy]. Response of American Casualty to CAT Fund's Request for Admissions, 2 (attached as exhibit B to exhibit C of American Casualty's Motion to Compel). American Casualty also admitted that it neither 1) completed or forwarded to the Office of the Director of the CAT Fund a Form 216 remittance advice relevant to surcharge collected on behalf of its insured [Nurse Sharon DiRienzo]; nor 2) forwarded to the office of the Director of the CAT Fund an acknowledgement of insurance and surcharge paid [Form 5116] or a copy of the declarations page of Policy No. NS03807436. Id. In summary, the Remittance Advice filed by Bryn Mawr Hospital (Form 5116) did not include a surcharge attributable to Nurse DiRienzo, i.e., PHICO collected no surcharge on behalf of Nurse DiRienzo. American Casualty never collected or submitted a surcharge on behalf of Nurse DiRienzo. The CAT Fund had no record of coverage for, or a surcharge payment by, or on behalf of, Nurse DiRienzo for the year 1988. Consequently, Nurse DiRienzo is not entitled to participate in the CAT Fund.