655.27 Injured patients and families compensation fund.

1,221 words·~6 min read·/wi/chapter-655/655-27

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(1)Fund. There is created an injured patients and families compensation fund for the purpose of paying that portion of a medical malpractice claim which is in excess of the limits expressed in s. 655.23

(4)or the maximum liability limit for which the health care provider is insured, whichever limit is greater, paying future medical expense payments under s. 655.015 , and paying claims under sub.

(1m). The fund shall provide occurrence coverage for claims against health care providers that have complied with this chapter, and against employees of those health care providers, and for reasonable and necessary expenses incurred in payment of claims and fund administrative expenses. The coverage provided by the fund shall begin July 1, 1975. The fund shall not be liable for damages for injury or death caused by an intentional crime, as defined under s. 939.12 , committed by a health care provider or an employee of a health care provider, whether or not the criminal conduct is the basis for a medical malpractice claim.

(1m)Peer review activities.

(a)The fund shall pay that portion of a claim described in par.

(b)against a health care provider that exceeds the limit expressed in s. 655.23

(4)or the maximum liability limit for which the health care provider is insured, whichever limit is greater.

(b)A health care provider who engages in the activities described in s. 146.37

(1g)and

(3)shall be liable for not more than the limits expressed under s. 655.23

(4)or the maximum liability limit for which the health care provider is insured, whichever limit is greater, if he or she is found to be liable under s. 146.37 , and the fund shall pay the excess amount, unless the health care provider is found not to have acted in good faith during those activities and the failure to act in good faith is found by the trier of fact, by clear and convincing evidence, to be both malicious and intentional.

(2)Fund administration and operation. Management of the fund shall be vested with the board of governors. The commissioner shall either provide staff services necessary for the operation of the fund or, with the approval of the board of governors, contract for all or part of these services. Such a contract is subject to s. 16.765 , but is otherwise exempt from subch. IV of ch. 16 . The commissioner shall adopt rules governing the procedures for creating and implementing these contracts before entering into the contracts. At least annually, the contractor shall report to the commissioner and to the board of governors regarding all expenses incurred and subcontracting arrangements. If the board of governors approves, the contractor may hire legal counsel as needed to provide staff services. The cost of contracting for staff services shall be funded from the appropriation under s. 20.145

(u). The fund shall pay to the commissioner amounts charged for organizational support services, which shall be credited to the appropriation account under s. 20.145

(g)2.

(3)Fees.

(a)Assessment. Each health care provider shall pay an annual assessment, which, subject to pars.

(b)to

(br), shall be based on the following considerations:

1. Past and prospective loss and expense experience in different types of practice.

2. The past and prospective loss and expense experience of the fund.

2m. The loss and expense experience of the individual health care provider which resulted in the payment of money, from the fund or other sources, for damages arising out of the rendering of medical care by the health care provider or an employee of the health care provider, except that an adjustment to a health care provider’s fees may not be made under this subdivision prior to the receipt of the recommendation of the injured patients and families compensation fund peer review council under s. 655.275

(a)and the expiration of the time period provided, under s. 655.275

(7), for the health care provider to comment or prior to the expiration of the time period under s. 655.275

(a).

3. Risk factors for persons who are semiretired or part-time professionals.

4. For a health care provider described in s. 655.002

(d),

(e),

(em), or

(f), risk factors and past and prospective loss and expense experience attributable to employees of that health care provider other than employees licensed as a physician or advanced practice registered nurse.

Effective date note NOTE: Subd. 4. is shown as amended eff. 9-1-26 by 2025 Wis. Act 17 . Prior to 9-1-26 it reads:

Effective date text 4. For a health care provider described in s. 655.002

(1)(d), (e), (em), or (f), risk factors and past and prospective loss and expense experience attributable to employees of that health care provider other than employees licensed as a physician or nurse anesthetist.

5. The supplemental appropriation under s. 20.145

(a)for payment of claims.

(am)Assessments for peer review council. The fund, a mandatory health care liability risk-sharing plan established under s. 619.04 , and a private health care liability insurer shall be assessed, as appropriate, fees sufficient to cover the costs of the injured patients and families compensation fund peer review council, including costs of administration, for reviewing claims paid by the fund or from the appropriation under s. 20.145

(a), by the plan, and by the insurer, respectively, under s. 655.275

(5). The fees shall be set by the commissioner by rule, after approval by the board of governors, and shall be collected by the commissioner for deposit in the fund. The costs of the injured patients and families compensation fund peer review council shall be funded from the appropriation under s. 20.145

(um).

(b)Fees established.

1. The commissioner, after approval by the board of governors, shall set the fees under par.

(a). The fees may be paid annually or in semiannual or quarterly installments. In addition to the prorated portion of the annual fee, semiannual and quarterly installments shall include an amount sufficient to cover interest not earned and administrative costs incurred because the fees were not paid on an annual basis. This paragraph does not impose liability on the board of governors for payment of any part of a fund deficit.

2. With respect to fees paid by physicians, the commissioner shall provide for no fewer than 4 payment classifications, based upon the amount of surgery performed and the risk of diagnostic and therapeutic services provided or procedures performed, by reference to the applicable Insurance Services Office, Inc., codes for specialties and types of practice that are similar in the degree of exposure to loss.

2m. In addition to the fees and payment classifications described under subds. 1. and 2. , the commissioner, after approval by the board of governors, may establish a separate payment classification for physicians satisfying s. 655.002

(b)and a separate fee for advanced practice registered nurses satisfying s. 655.002

(b)which take into account the loss experience of health care providers for whom Michigan is a principal place of practice.

Effective date note NOTE: Subd. 2m. is shown as amended eff. 9-1-26 by 2025 Wis. Act 17 . Prior to 9-1-26 it reads: