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Lee M. Duke, MD
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Mary Beth Schweigert
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Healthcare Professionals / Progress Notes / Government Affairs / Act now to receive your Mcare refund

Act now to receive your Mcare refund

From The Pennsylvania Medical Society
Physicians must act by Sept. 18 to receive refunds for overpayments to Pennsylvania’s Mcare Fund.
The first round of refunds is expected in early 2016.
According to a 2014 settlement, physicians are eligible to receive refunds for overpayments made from 2009 to 2014 (with the exception of 2013). The impact on employed physicians varies based on the physician’s status during the specific years covered by the litigation.
If a physician paid an assessment -- or an assessment was paid for him or her -- for any coverage period beginning in those years, the physician is eligible for a refund. In some cases, medical practices pay an assessment for separate coverage for the practice (in addition to the coverage of the practice professionals). These practices also will be eligible for refunds for each covered assessment.
Each physician or other healthcare provider will control who is paid the refund for their lines of coverage by Mcare, even if the assessment was paid by another person or entity, such a medical practice, hospital or health system.
Refunds will be paid to the assessed healthcare provider, unless:

  • He or she assigns the right to payment to another person or entity that paid the assessment.

  • He or she agrees to a claim made on the refund by the assessment payor or fails to make a choice as to who should be paid on a claim made by the assessment payor.

  • Notice of the refund(s) is undeliverable due to an incorrect mailing address.

The settlement does not, however, alter any legal right that a person or entity that paid the assessment may have to the refund – outside of the settlement, such as via an employment contract.
Depending on the circumstances, it may be in a healthcare provider's best interests to remit a refund to the assessment payor through the assignment or claim processes.
Claims must be made during the claim period, which ends Sept. 18. The first round of refund notices is expected to be mailed in the fall.
A first round of refund payments is tentatively scheduled for early 2016. A second round of payments will be made later in 2016, after a second round of refund notices and the final deadline for healthcare providers to make choices on claimed refunds.


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