N.M. Admin. Code § 13.21.2.10 - FINANCIAL RESPONSIBILITY - SELF-INSURANCE
An independent provider may qualify for admission to the fund by having continuously on deposit the sum of $750,000 in cash, as long as the following conditions are met:
A.
The deposit shall be conditioned only for, dedicated exclusively to, and held
in trust for the benefit and protection of and as security for the prompt
payment of all medical malpractice claims arising or asserted against the
health care provider.
B. A
self-insured health care provider shall be required to execute a pledge
agreement for the money on deposit prescribed and supplied by the
superintendent.
C. Sums on deposit
with the superintendent pursuant to this rule shall not be assigned,
transferred, mortgaged, pledged, hypothecated, or otherwise encumbered by the
health care provider nor shall any such deposit be subject to writ of
attachment, sequestration, or execution except pursuant to a final judgment or
court-approved settlement issued or made in connection with and arising out of
a malpractice claim against the health care provider.
D. To maintain financial responsibility for
continuing qualification with the fund, a self-insured health care provider
shall at all times maintain the sum on deposit provided for by this rule at not
less than $750,000. The value of the health care provider's deposit shall be
deemed impaired when any portion is seized or released pursuant to judicial
process.
E. In the event that a
self-insured health care provider's deposit provided for by this rule becomes
impaired, the superintendent shall give written notice of such impairment to
the self-insured health care provider, and the self-insured health care
provider shall, unless a longer period is provided for by the superintendent,
have five days from receipt of such notice to make such additional deposit as
will restore the minimum deposit value prescribed by this rule. A self-insured
health care provider's qualification with the fund shall terminate on and as of
the later of the last day set by these rules or, if applicable, by the
superintendent, if the self-insured health care provider has not on or prior to
such date restored the minimum deposit value prescribed by this rule. In the
case of multiple self-insured health care providers approved by the
superintendent to post one deposit, as set forth in Subsection B of this
section, the admission to the fund of each member of the group or each related
entity shall terminate on and as of the last day set by these rules or, if
applicable, by the superintendent, if the self-insured health care provider has
not on or prior to such date restored the minimum deposit value prescribed by
this rule.
F. A self-insured health
care provider shall, within 120 days of receiving notice of a request for
review of a malpractice claim, submit a report to the superintendent and the
TPA of the anticipated exposure to the fund and the self-insured health care
provider and containing sufficient details supporting the anticipated exposure.
In addition, said self-insured heath care provider shall provide updates to the
superintendent and the TPA when significant changes in anticipated exposure
occur.
G. A self-insured health
care provider who has evidenced financial responsibility pursuant to this rule
may withdraw the deposit prescribed by this rule upon authorization of the
superintendent. All money shall remain on deposit and pledged to the fund
during the term of the health care provider's admission as a self-insured
health care provider with the fund and for the longer of a three-year period
following termination of such admission or as long as any medical malpractice
claim is pending, whether with the medical review commission or in a court of
competent jurisdiction. After this time period, authorization may be given when
the health care provider files with the superintendent and the TPA, not less
than 30 days prior to the date such withdrawal is to be effected, a certificate
signed by the health care provider, certifying:
(1) the date the health care provider
terminated admission to the fund as a self-insured health care
provider;
(2) that there are no
medical malpractice claims pending with the medical review commission or in a
court of competent jurisdiction;
(3) that there are no unpaid final judgments
or settlements against or made by the health care provider in connection with
or arising out of a malpractice claim; and
(4) that there are no unasserted medical
malpractice claims which are probable of assertion against the health care
provider.
H. Effective
as of the date on which a self-insured health care provider's deposit is
withdrawn pursuant to this rule, the health care provider's admission to and
qualification with the fund shall be terminated.
I. The deposit with the superintendent shall
provide coverage for not more than three separate occurrences, and the limit
that shall be paid from the deposit for each occurrence is $250,000.
J. The acceptance by the superintendent of
the self-insurance deposit described in this rule does not create in the
superintendent, the TPA, or the fund a duty to defend any health care provider
making a deposit under this rule.
Notes
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