January 1 2022

Commonwealth of Pennsylvania Mcare Assessment Manual January 1 2022 Tom Wolf, Governor Jessica K. Altman, Insurance Commissioner 12%2022 Assessment Manual 1 Contents CONTENTS INTRODUCTION 3 MCARE PARTICIPATION 3 2022 MCARE LIMITS 4 EXEMPTIONS 4 CONTACTING MCARE 4 SECTION I REMITTANCE ADVICE FORM (Form e-216) 5 Information Submissions 6 SECTION II REPORTING GUIDELINES 7 Balances Column License and Assigned Numbers 12 SECTION III CALCULATING THE MCARE ASSESSMENT 13 , Podiatrists, and Certified Nurse Midwives Corporations, Associations and Companies, and Partnerships Homes Health Centers Centers Entities Telemedicine or Camp Licenses 20 SECTION IV ADDITIONAL ASSESSMENT RATING FACTORS 20 Physicians or New Podiatrists and Fellows Positions Rating 23 SECTION V NONPARTICIPATING TRANSMITTAL FORMS (Form e-316 & Form e-316CV) 24 Information e-316 e-316CV Submissions 242022 Assessment Manual 2 Contents SECTION VI CLAIMS MADE COVERAGE REQUIREMENTS AND REPORTING 24 Information Reporting Coverage Extended Reporting Coverage Generally Extended Reporting Coverage with a Retroactive Date Prior to January 1, 1997 Tail (IT) 25 SECTION VII DEFINITIONS 26 SECTION VIII FORM e-216 REVIEW & CHECKLIST 27 Review - Checklist - 27 SECTION IX CHANGES TO MEDICAL SPECIALTIES/TERRITORIES 28 SECTION X LIST OF

D. Reporting Extended Reporting Coverage with a Retroactive Date Prior to January 1, 1997 – 25 E. Interim Tail (IT) – 25. SECTION VII – DEFINITIONS – 26. SECTION VIII – FORM e-216 REVIEW & CHECKLIST – 27 A. e-216 Review - 27. B. e-216 Checklist - 27.

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