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TITLE 760 DEPARTMENT OF INSURANCE

Proposed Rule
LSA Document #18-70

DIGEST

Adds 760 IAC 1-60-1.1 concerning definitions. Amends 760 IAC 1-60-3 regarding physician specialty classes. Amends 760 IAC 1-60-5 regarding part-time and retired physicians. Adds 760 IAC 1-60-6 regarding surcharge owed by physicians holding multiple policies. Repeals 760 IAC 1-60-2. Effective 30 days after filing with the Publisher.




SECTION 1. 760 IAC 1-60-1.1 IS ADDED TO READ AS FOLLOWS:

760 IAC 1-60-1.1 Definitions

Authority: IC 34-18-5-2
Affected: IC 34-18-5-2

Sec. 1.1. (a) The following definitions apply throughout this rule:
(1) "Locum tenens" means a health care provider who:
(A) is an independent contractor; and
(B) provides services on a temporary assignment with an unrelated entity when:
(i) the unrelated entity's employed health care provider or providers are away or unavailable; or
(ii) additional staffing is required by the unrelated entity.
(2) "Major surgery" means a physician who performs or assists in the performance of any medical procedures requiring the use of:
(A) moderate sedation/analgesia;
(B) deep sedation/analgesia;
(C) regional anesthesia; or
(D) general anesthesia.
For the purposes of emergency medicine, the term means a physician practicing in a trauma center.
(3) "Minor surgery" means a physician who performs or assists in the performance of any medical procedures requiring the use of:
(A) local anesthesia;
(B) superficial nerve blocks; or
(C) minimal sedation/anxiolysis.
For the purposes of emergency medicine, the term means a physician practicing in a hospital-based emergency department that is not a trauma center.
(4) "No surgery" means a physician who neither performs nor assists in the performance of major surgery or minor surgery.
(5) "PCF" means the Indiana patient's compensation fund.
(6) "Retired physician" means a physician who has ceased practicing for compensation, but retains an active Indiana license. For purposes of this rule, a physician who volunteers for any amount of time without prescriptive authority is considered a retired physician.
(7) "Surgery (not otherwise classified)" means a physician who:
(A) performs; or
(B) assists in the performance of;
major surgery or minor surgery.

(b) Any term not defined in this rule has the meaning set forth in 844 IAC 5-5.
(Department of Insurance; 760 IAC 1-60-1.1)


SECTION 2. 760 IAC 1-60-3 IS AMENDED TO READ AS FOLLOWS:

760 IAC 1-60-3 List of physician specialty classes

Authority: IC 34-18-5-2
Affected: IC 34-18-5-2

Sec. 3. The list of physician specialty classes required by IC 34-18-5-2 is as follows:
Indiana Department of Insurance 
Patient's Compensation Fund 
Physician Class Plan 
Class 0 
ISO Code  Specialty 
80001  Resident Nonmoonlighting 
80221  Resident Moonlighting (No ER) 
80230  Aerospace Medicine 
80231  General Preventive Medicine – No Surgery 
80233  Occupational Medicine 
80234  Pharmacology – Clinical 
80236  Public Health 
80240  Legal Medicine and Forensic Medicine 
80248  Nutrition 
80249  Psychiatry (Including Child) 
80250  Psychoanalysis 
80251  Psychosomatic Medicine 
80254  Allergy 
80256  Dermatology – No Surgery 
80263  Ophthalmology – No Surgery 
80266  Pathology – No Surgery 
Class 1 
ISO Code  Specialty 
80233  Occupational Medicine 
80235  Physical Medicine and Rehabilitation 
80237  Diabetes – No Surgery 
80238  Endocrinology – No Surgery 
80239  Family Practice – No Surgery 
80241  Gastroenterology – No Surgery 
80242  General Practice – No Surgery 
80243  Geriatrics – No Surgery 
80244  Gynecology – No Surgery 
80245  Hematology – No Surgery 
80246  Infectious Disease – No Surgery 
80247  Rhinology – No Surgery 
80252  Rheumatology – No Surgery 
80255  Cardiovascular Disease – No Surgery 
80257  Internal Medicine – No Surgery 
80258  Laryngology – No Surgery 
80259  Neoplastic Disease – No Surgery 
80260  Nephrology – No Surgery 
80261  Neurology (Including Child) – No Surgery 
80262  Nuclear Medicine 
80264  Otology – No Surgery 
80265  Otorhinolaryngology – No Surgery 
80266  Pathology – No Surgery 
80267  Pediatrics – No Surgery 
80268  Physicians (Not Otherwise Classified) – No Surgery 
80269  Pulmonary Disease – No Surgery 
80420  Family Physicians – No Surgery 
80473  Oncology (Not Otherwise Classified) 
Class 2 
ISO Code  Specialty 
80223  Resident Moonlighting (with ER) 
80253  Radiology – No Surgery Therapeutic 
80261  Neurology – (Including Child) – No Surgery 
80280  Radiology – Minor Surgery Diagnostic 
80282  Dermatology – Minor Surgery (including but not limited to liposuction – tumescent technique, deep chemical peels, skin flaps – cosmetic, grafts – cosmetic) 
80289  Ophthalmology – Minor Surgery (including but not limited to ectropion repair, entropion repair and excision of growths in area of eye and lids) 
80292  Pathology – Minor Surgery 
80425  Radiation Therapy – Not Otherwise Classified 
80426  Radiation Oncology 
80431  Shock Therapy 
Class 3 
ISO Code  Specialty 
80109  Physicians – No Major Surgery 
80114  Surgery – Ophthalmology (including but not limited to cataract surgery, blepharoplasty, and LASIK/refractive surgery) 
80132  Physicians (Not Otherwise Classified) – Minor Surgery 
80151  Surgery – Anesthesiology 
80163  Radiation Therapy – Employed Physicians or Surgeons with Major Surgery 
80172  Physician Physicians (Not Otherwise Classified) – No Major Surgery 
80270  Rhinology – Minor Surgery 
80271  Diabetes – Minor Surgery 
80272  Endocrinology – Minor Surgery 
80273  Family Practice – Minor Surgery (including but not limited to vasectomy, lumbar epidural steroid nerve block, and circumcision) 
80274  Gastroenterology – Minor Surgery (including but not limited to colonoscopy, endoscopic biopsy, upper GI endoscopy – ERCP, gastrotomy, and duodenoscopy) 
80275  General Practice – Minor Surgery 
80276  Geriatrics – Minor Surgery 
80277  Gynecology – Minor Surgery 
80278  Hematology – Minor Surgery 
80279  Infectious Diseases – Minor Surgery 
80281  Cardiovascular Disease – Minor Surgery (including but not limited to catheterization – left heart, angioplasty, electrophysiological studies – left heart) 
80283  Intensive Care Medicine – Minor Surgery 
80284  Internal Medicine – Minor Surgery (including but not limited to gastrointestinal endoscopy and biopsy – endoscopic) 
80285  Laryngology – Minor Surgery (including but not limited to endoscopic biopsy and lymph node excision) 
80286  Neoplastic Diseases – Minor Surgery 
80287  Nephrology – Minor Surgery 
80288  Neurology (Including Child) – Minor Surgery (including but not limited to lumbar epidural steroid – nerve block, myelography, angiography, and arteriography) 
80290  Otology – Minor Surgery (including but not limited to endoscopic biopsy and lymph node excision) 
80291  Otorhinolaryngology – Minor Surgery 
80293  Pediatrics – Minor Surgery (including but not limited to colonoscopy, ERCP, esophagoscopy, and pulmonary artery catheterization) 
80294  Physicians (Not Otherwise Classified) – Minor Surgery 
80421  Family Physicians (GP) – Minor Surgery – No OB 
80422  Catheterization (Not Otherwise Classified) 
80424  Emergency Medicine – No Surgery 
80474  Oncology – Minor Surgery 
Class 4 
ISO Code  Specialty 
80000  Family Practice – with OB (including but not limited to prenatal practice to delivery, with or without delivery and tubal ligations) 
80101  Broncho-Esophagology 
80108  Physicians – Surgery – Nephrology 
80115  Surgery (Not Otherwise Classified) – Colon and Rectal (including family practice with colonoscopy and internal medicine with colonoscopy) 
80117  Surgery (Not Otherwise Classified) – GP (Not Primarily Engaged in Surgery) 
80145  Surgery (Not Otherwise Classified) – Urological 
80151  Surgery – Anesthesiology 
80163  Radiation Therapy – Employed Physicians or Surgeons with Major Surgery 
80277  Gynecology – Minor Surgery 
80428  Physicians – Minor Invasive Procedures – Myelography 
80434  Physicians – Minor Invasive Procedures – Lymphangiography 
80437  Physicians – Minor Invasive Procedures – Acupuncture 
80440  Physicians – Minor Invasive Procedures – Laparoscopy 
80443  Physicians – Minor Invasive Procedures – Colonoscopy 
80446  Physicians – Minor Invasive Procedures – Needle Biopsy 
80449  Radiopaque Dye Injection 
Class 5 
ISO Code  Specialty 
80102  Emergency Medicine – No Major Surgery 
80103  Physicians – Surgery (Not Otherwise Classified) – Endocrinology 
80104  Physicians – Surgery (Not Otherwise Classified) – Gastroenterology 
80105  Physicians – Surgery (Not Otherwise Classified) – Geriatrics 
80106  Surgery (Not Otherwise Classified) – Laryngology (including but not limited to rhinoplasty, reconstructive blepharoplasty, tonsillectomy, adenoidectomy, reconstructive cleft palate surgery, and mastoidectomy) 
80107  Physicians – Surgery (Not Otherwise Classified) – Neoplastic 
80108  Physicians – Surgery – Nephrology 
80155  Surgery – Plastic – Otorhinolaryngology 
80158  Surgery (Not Otherwise Classified) – Otology (including but not limited to rhinoplasty, reconstructive blepharoplasty, tonsillectomy, adenoidectomy, reconstructive cleft palate surgery, and mastoidectomy) 
80159  Surgery (Not Otherwise Classified) – Otorhinolaryngology (including but not limited to rhinoplasty, reconstructive blepharoplasty, tonsillectomy, adenoidectomy, reconstructive cleft palate surgery, and mastoidectomy) 
80160  Physicians – Surgery (Not Otherwise Classified) – Rhinology (including but not limited to rhinoplasty, reconstructive blepharoplasty, tonsillectomy, adenoidectomy, reconstructive cleft palate surgery, and mastoidectomy) 
80419  Family or General Practice – Major Surgery 
80475  Pain Medicine and Pain Management 
Class 6 
ISO Code  Specialty 
80141  Surgery – Cardiac 
80143  Surgery (Not Otherwise Classified) – General Not Otherwise Classified 
80155  Surgery – Plastic – Otorhinolaryngology 
80156  Surgery (Not Otherwise Classified) – Plastic Not Otherwise Classified 
80157  Surgery (Not Otherwise Classified) – Emergency Medicine 
80166  Surgery (Not Otherwise Classified) – Abdominal 
80167  Surgery – Gynecology 
80169  Surgery (Not Otherwise Classified) – Hand 
80170  Surgery (Not Otherwise Classified) – Head and Neck 
Class 7 
ISO Code  Specialty 
80141  Surgery (Not Otherwise Classified) – Cardiac 
80144  Surgery (Not Otherwise Classified) – Thoracic 
80146  Surgery (Not Otherwise Classified) – Vascular 
80150  Surgery (Not Otherwise Classified) – Cardiovascular Disease (including cardiovascular surgeons) 
80154  Surgery (Not Otherwise Classified) – Orthopedic 
80167  Surgery (Not Otherwise Classified) – Gynecology 
80171  Surgery (Not Otherwise Classified) – Traumatic 
80476  Surgery (Not Otherwise Classified) – Bariatric 
Class 8 
ISO Code  Specialty 
80152  Surgery – Neurology (Including Child) 
80153  Surgery (Not Otherwise Classified) – Obstetrics/Gynecology 
80168  Surgery (Not Otherwise Classified) – Obstetrics 
Class 9 
ISO Code  Specialty 
80152  Surgery (Not Otherwise Classified) – Neurology (Including Child) 
(Department of Insurance; 760 IAC 1-60-3; filed Oct 23, 1998, 2:45 p.m.: 22 IR 754; filed Aug 6, 1999, 2:35 p.m.: 22 IR 3934; filed Apr 26, 2004, 2:00 p.m.: 27 IR 2729, eff Jul 1, 2004; readopted filed Nov 24, 2010, 9:17 a.m.: 20101222-IR-760100633RFA; readopted filed Nov 23, 2016, 9:47 a.m.: 20161221-IR-760160436RFA)


SECTION 3. 760 IAC 1-60-5 IS AMENDED TO READ AS FOLLOWS:

760 IAC 1-60-5 Part-time and retired physicians

Authority: IC 34-18-5-2
Affected: IC 25-22.5-1-1.1

Sec. 5. (a) A physician who practices medicine on a part-time basis shall pay a reduced surcharge as follows:
(1) A physician who practices medicine twelve (12) hours per week or less shall receive a credit equal to seventy-five percent (75%) of the surcharge amount.
(2) A physician who practices medicine more than twelve (12) hours but less fewer than twenty-five (25) hours per week shall receive a credit equal to fifty percent (50%) of the surcharge amount.
(3) A physician who practices medicine more than twenty-five (25) hours per week but fewer than to thirty-one (31) hours per week shall receive a credit equal to twenty-five percent (25%) of the surcharge amount.

(b) Medical school faculty shall receive a credit equal to sixty-seven percent (67%) of the surcharge amount. As used in this subsection, "medical school faculty" means a physician engaged in research or teaching at a medical school as defined in IC 25-22.5-1-1.1(h). To be eligible for the credit, not more than thirty percent (30%) of the physician's time may be spent treating patients whose treatment is unrelated to the physician's duties at the medical school.

(c) Newly licensed physicians shall receive a credit equal to fifty percent (50%) of the surcharge amount during their first year of practice and twenty-five percent (25%) during their second year. For purposes of this subsection, a physician is considered newly licensed for two (2) years after:
(1) completion of a residency program or a fellowship program in their medical specialty; or
(2) the fulfillment of a military obligation in remuneration for medical school tuition.

(d) A physician participating in a fellowship program shall pay the following:
(1) If the fellowship is full time and the physician is engaging in no other medical practice, the physician shall pay an annual surcharge equal to fifty percent (50%) of the surcharge due for the specialty class of the fellowship.
(2) If the physician is engaging in a medical practice outside of the fellowship, the physician shall pay the greater of the following:
(A) The full-time surcharge due for the medical practice outside of the fellowship.
(B) Fifty percent (50%) of the surcharge due for the specialty class of the fellowship.
For purposes of this subsection, "part-time" has the meaning described in subsection (a)(2).

(e) A retired physician shall pay an annual surcharge in the amount of five hundred dollars ($500).

(f) Not more than one (1) credit may be applied to a physician in any policy year.
(Department of Insurance; 760 IAC 1-60-5; filed Oct 23, 1998, 2:45 p.m.: 22 IR 756; filed Aug 6, 1999, 2:35 p.m.: 22 IR 3936; filed Apr 26, 2004, 2:00 p.m.: 27 IR 2730, eff Jul 1, 2004; filed Aug 23, 2006, 3:58 p.m.: 20060906-IR-760050266FRA; readopted filed Nov 24, 2010, 9:17 a.m.: 20101222-IR-760100633RFA; readopted filed Nov 23, 2016, 9:47 a.m.: 20161221-IR-760160436RFA)


SECTION 4. 760 IAC 1-60-6 IS ADDED TO READ AS FOLLOWS:

760 IAC 1-60-6 Multiple policies

Authority: IC 34-18-5-2
Affected: IC 34-18-5-2

Sec. 6. (a) A physician who purchases more than one (1) professional liability insurance policy may pay only one (1) full-time surcharge.

(b) A physician shall remit the following surcharge to the PCF for the second policy:
(1) If the second policy that is being reported for proof of financial responsibility is at a lower classification than the first policy, the physician shall remit the minimum surcharge set forth in 760 IAC 1-21 to the PCF for the second policy.
(2) If the second policy that is being reported for proof of financial responsibility is at a higher classification than the first policy, the physician shall remit the difference between the higher classification surcharge and the lower classification surcharge to the PCF for the second policy.

(c) This section does not apply to physicians holding part-time policies or locum tenens policies as the first policy being reported for proof of financial responsibility. A physician shall remit one (1) full-time surcharge on the first policy before calculating the surcharge to be remitted on the second policy.
(Department of Insurance; 760 IAC 1-60-6)


SECTION 5. 760 IAC 1-60-2 IS REPEALED.


Posted: 04/11/2018 by Legislative Services Agency

DIN: 20180411-IR-760180070PRA
Composed: Apr 26,2024 5:33:00PM EDT
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