M.G.L.A. 175 §§ 193U. Discrimination based on specialty practiced; risk classification; definitions

Every medical malpractice insurer shall make available to every health care provider every primary medical malpractice insurance coverage, as defined in the plan or rules of operation of the medical malpractice reinsurance plan, which it provides to any health care provider; provided, however, that only a medical malpractice insurer may cede any primary medical malpractice insurance policy issued to a health care provider to the medical malpractice reinsurance plan.

No medical malpractice insurer shall discriminate against any health care provider based upon the specialty practiced by health care providers within such category; provided, however, that nothing herein shall prohibit a medical malpractice insurer from establishing reasonable classifications of risks and premium charges based upon the relative risk associated with practice in a particular specialty. If, after a hearing, the commissioner determines that a medical malpractice insurer has discriminated against any health care provider in violation of this section, the commissioner shall take such action as is necessary to eliminate the effect of the discrimination and to prevent further violations, including, without limitation, the suspension or revocation of the medical malpractice insurer's license, admission, authorization or approval to write medical malpractice insurance on risks within the commonwealth.

For purposes of this section, the following words shall have the following meanings:--

"Health care provider", any category of health care provider that was authorized to obtain medical malpractice insurance from the Joint Underwriting Association established by section 6 of chapter 362 of the acts of 1975, including but not limited to, a doctor of medicine, osteopathy, optometry, dental science, podiatry, chiropractic, or registered nurse licensed under the provisions of chapter 112, an intern, fellow or medical officer licensed under the provisions of section 9 of said chapter 112 or a licensed hospital, clinic, or nursing home, and its agents and employees, and any other category of health care provider as the commissioner of insurance may from time to time designate as eligible for being ceded to the medical malpractice reinsurance plan.

"Medical malpractice insurer", any corporation that is licensed, admitted, authorized or approved to write liability other than auto insurance on risks within the commonwealth on a direct basis. The term "medical malpractice insurer" shall not include: (1) a corporation or other entity that is formed under the laws of any jurisdiction other than a state of the United States or the District of Columbia and that is engaged in writing (i) medical malpractice insurance for the members, shareholders or owners of such corporation or other entity, including affiliates of such members, shareholders, owners and persons employed by, affiliated with or providing professional services to such members, shareholders, owners or affiliates, and any servicing carrier thereof, or (ii) reinsurance on medical malpractice insurance written by a fronting company for the members, shareholders or owners of such corporation or other entity, including affiliates of such members, shareholders, owners or affiliates, and any servicing carrier thereof; (2) a trust maintained by the University of Massachusetts to self fund medical malpractice risks; (3) a risk retention group, as defined in the Liability Risk Retention Act of 1986, 15 U.S.C. 3901; or (4) a surplus lines insurer, so-called, insuring in the commonwealth under the requirements of section 168.

1. Due process

Insured physician who is subject of remedial action by experience review committee of Medical Professional Mutual Insurance Company (MPMIC) has adequate due process protection, assuming that committee action causes a deprivation of property and involves state action, by reason of his or her access to judicial system for review of committee's decision on merits prior to implementation of any remedial action. Massand v. Medical Professional Mut. Ins. Co. (1995) 651 N.E.2d 403, 420 Mass. 690. Constitutional Law  287.2(5); Health  223(1)

Physician was not denied procedural due process when experience review committee refused to allow his attorney to be present at informal committee meeting; since adequate judicial review of committee's determination existed, any additional benefit associated with having attorney present at initial meeting would not outweigh administration burden imposed on committee. Massand v. Medical Professional Mut. Ins. Co. (1995) 651 N.E.2d 403, 420 Mass. 690. Constitutional Law  287.2(5); Health  219

Notice provided insured physician of proposed remedial action by experience review committee and reasons supporting determination satisfied any due process requirement, regardless of fact that notice did not specify nature, kind or number of malpractice claims on which committee relied. Massand v. Medical Professional Mut. Ins. Co. (1995) 651 N.E.2d 403, 420 Mass. 690. Constitutional Law  287.2(5); Health  219

2. Delegation

Statute authorizing experience review committee of Medical Professional Mutual Insurance Company (MPMIC) to impose remedial action upon insured physician to lower risk of future malpractice did not delegate to committee authority within exclusive jurisdiction of board of registration of medicine. Massand v. Medical Professional Mut. Ins. Co. (1995) 651 N.E.2d 403, 420 Mass. 690. Health  203