The rising cost of malpractice insurance has led many tax-exempt hospitals to search for ways to assist the physicians on their medical staffs in obtaining reasonably priced malpractice insurance coverage. In a letter to the IRS, the OIG, and CMS, the American Health Lawyers Association is seeking clarification and guidance regarding ways that health care facilities can lawfully assist their physicians through malpractice insurance support programs. The letter addresses two methods--subsidized programs through discounted insurance rates or direct cash payment to physicians or the insurance company; or alternatively, through allowing physicians to participate in a hospital's self-insurance program or captive insurance company at actuarial or market-based rates. AHLA lays out the characteristics of each of these approaches in the letter, suggests criteria that may be applicable to any support program, such as not basing benefits on the volume or value of referrals, and requests coordinated guidance from the agencies.
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