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While obstetricians and other delivering providers may become participants in the Birth-Injury Program, all other licensed Virginia physicians also play a key role. The Virginia General Assembly established the Program to help hold down malpractice insurance rates for all physicians, which studies show it has accomplished.* As a part of the original statute (§38.2-5020), when deemed necessary by the Virginia Bureau of Insurance, all non-participating licensed physicians in Virginia, of any specialty, are assessed an annual $250 fee to help fund the Program. (Other times participant fees are the only income, no state general funds are provided to the Birth-Injury Program) This physician assessment has been implemented about half of the years since the Program’s creation, and currently is in place. Whenever the physician assessment is implemented, an assessment on liability insurers operating in Virginia also is implemented. Physician assessments currently provide less than 20 percent of the Program’s annual income.
2010 Exemption Form
State law allows for five exemptions to paying the physician assessment.
They are:
1. A physician who is employed by the Commonwealth of Virginia or the federal government and whose income from professional fees is less than 10% of my annual salary.
2. A physician who is enrolled in a full-time graduate medical education program accredited by the American Council for Graduate Medical Education.
3. A physician who has retired from active clinical practice.
4. A physician whose active clinical practice is limited to the provision of services, voluntarily and without compensation, to any patient of any clinic organized in whole or in part for the delivery of health care services without charge.
5. A physician who does not practice medicine in Virginia.
A physician may claim one of the above exemptions by completing the Birth-Injury Program’s Physician Exemption Form, having it notarized and returning it to the Program during the assessment process.
Enforcement
The
Birth-Injury Program is required to turn over the names of any non-responding
physicians to the State Corporation Commission’s
Bureau of Insurance for enforcement. The State Corporation Commission
may impose a fine of up to $5,000.
*Virginia General Assembly’s Joint Legislative Audit & Review Commission, Review of the Virginia Birth-Related Neurological Injury Compensation Program, 2002, page 32.
Frequently
Asked Questions About
Annual Assessment Process
1. I am not an obstetrician and I do not deliver babies, do I have to pay this assessment?
3. I am retired from practice; do I have to pay the assessment?
5. I only worked part of the year; do I have to pay the assessment?
6. I only worked part-time; do I have to pay the full assessment?
8. If I pay the assessment, does that make me a participating physician in the Birth-Injury Program?
9. What happens if I do not respond to this assessment?
10. Why did I receive a “Rule To Show Cause” from the Virginia Bureau of Insurance?
13. Who regulates the Virginia Birth-Related Neurological Injury Compensation Program?
14. Are physicians the only source of income for the Birth-Injury Program?
15. Where can I see the legislation establishing and authorizing the Birth-Injury Program?
16. What qualifies a child to enter the program?
17. I want to make comments about the Program, whom do I contact?
18. Where can I find out more about the Birth-Injury Program?
Q. 1. I am not an obstetrician and I do not deliver babies, do I have to pay this assessment?
A. The assessment applies to all Virginia licensed physicians regardless of specialty or income. However, if you meet one of the five exemption categories you may file an exemption affidavit instead of paying the assessment. If you become a participating provider and pay the $5,000 annual fee you do not have to pay the additional assessment.
Q. 2. I have an active medical license but do not actively practice in Virginia; do I have to pay the assessment?
A. You may meet the criteria for an exemption. Please see the exemption affidavit.
Q. 3. I am retired from practice; do I have to pay the assessment?
A. If you retired prior to September 30 of the preceding year, you do not have to pay the assessment. For example, if you retired in June 2005, you would not owe the 2006 assessment. However, you must submit an exemption affidavit.
Q. 4. I work for an organization funded by the Commonwealth of Virginia or federal government, do I have to pay the assessment?
A. If you are paid directly by the state or the federal government then you are usually exempt. However, if you are paid through an intermediary (such as a Community Services Board or federal contractor) then you must pay the assessment.
Q. 5. I only worked part of the year; do I have to pay the assessment?
A. State law bases the assessment on your status as of September 30 of the year prior to the assessment year. For example, for the 2006 assessment year, your status was based on whether or not you were practicing in Virginia as of September 30, 2005.
Q. 6. I only worked part-time; do I have to pay the full assessment?
A. The statute does not provide for any prorating or discounts based on hours worked for the non-participating assessment.
Q. 7. Even though I was actively practicing as of September 30, I only had a limited income. Do I have to pay the assessment?
A. The statute does not provide for any prorating or discounts based on income level. The only exception is as listed above under exemption number 4.
Q. 8. If I pay the assessment, does that make me a participating physician in the Birth-Injury Program?
A. No. To become a participating physician you must pay the participating physician fee and sign a participating provider agreement.
Q. 9. What happens if I do not respond to this assessment?
A. The Program is required to turn over the names of all non-compliant physicians to the State Corporation Commission for enforcement.
Q. 10. Why did I receive a “Rule To Show Cause” from the Virginia Bureau of Insurance?
A. By law, the Birth-Injury Program is required to provide the Bureau of Insurance with the names of all physicians who do not respond to the three assessment notices. The Bureau then issues a Rule To Show Cause, which requires that you inform them why you did not pay the assessment for that year. If there is no response, other enforcement measures are taken.
Q. 11. Where did the Birth-Injury Program get my address? Why was the assessment sent to my home address?
A. Physician addresses are obtained from the Virginia Board Of Medicine. Per state law, the list is based on physicians practicing in Virginia on September 30 of the year prior to the assessment year. Whatever address you have on file with them is the address utilized for the assessment mailing. You can change your address of record by contacting the Board of Medicine.
Q. 12. How is this money used?
A. All fees and assessments are utilized by the Virginia Birth-Related Neurological Compensation Program to provide medically necessary care for children in the Program. The Birth-Injury Program operates according to its authorizing statutes in the Code of Virginia ‚ §38.2 ‚ 5000 through 5021.
Q. 13. Who regulates the Virginia Birth-Related Neurological Injury Compensation Program?
A. The Program is regulated by statute in a variety of ways including:
- The Code of Virginia is very specific in how the Program is to operate. Additionally, a Plan of Operation is approved by the State Corporation Commission.
- All admissions into the program are through the Virginia Workers’ Compensation Commission. The Program itself does not admit claimants.
- The Program is required to file an annual financial report, including information regarding its reserve funds, to the Governor’s office, the Virginia Senate and the Virginia House of Delegates.
- The Governor appoints all governing board members for the Program.
- At least every-other year, the State Corporation Commission is required to conduct an actuarial study of the Program.
Q. 14. Are physicians the only source of income for the Birth-Injury Program?
A. No. There are four sources of income.
- Participating-provider fees.
- Participating hospital fees.
- Non-participating physician assessments.
- Assessments of insurance companies selling liability insurance in Virginia.
Mandatory physician assessments provide about 20 percent of the Program’s revenue.
Q. 15. Where can I see the legislation establishing and authorizing the Birth-Injury Program?
A. Code of Virginia, Chapter 50, SS 38.2 ‚ 5000 through 38.2 ‚ 5021.
This may be viewed on-line via the Commonwealth’s website http://leg1.state.va.us/lis.htm
Q. 16. What qualifies a child to enter the program?
A. From §38.2-5001 of the Code of Virginia:
“Birth-related neurological injury” means injury to the brain or spinal cord of an infant caused by the deprivation of oxygen or mechanical injury occurring in the course of labor, delivery or resuscitation in the immediate post-delivery period in a hospital which renders the infant permanently motorically disabled and (i) developmentally disabled or (ii) for infants sufficiently developed to be cognitively evaluated, cognately disabled. In order to constitute a “birth-related neurological injury” within the meaning of this chapter, such disability shall cause the infant to be permanently in need of assistance in all activities of daily living.
Per applicable law, entry into the Program is decided solely by the Virginia Workers’ Compensation Commission.
Q. 17. I want to make comments about the Program, whom do I contact?
A. If your comments are administrative in nature, please contact the Birth-Injury Program.
If your comments concern the overall purpose of the Birth-Injury Program, you may contact either the Program or your state legislators. Because the Program was established by the Virginia General Assembly, they are the only body with authority to alter or make changes. The General Assembly website allows you to determine who your representatives are.
Q. 18. Where can I find out more about the Birth-Injury Program?
A. Please start by viewing this entire website. If you have additional questions the Program staff will be glad to assist you. Additionally, the Birth-Injury Program is subject to the Freedom Of Information Act.