Coverage
Insurers and self-insureds have the responsibility to make certain that the applicable Mcare assessment is timely collected, reported and remitted to Mcare on behalf of each participating health care provider and eligible entity it insures. These reports and remittances must be received by Mcare within 60 calendar days of the issuance (inception) of a basic insurance coverage policy.
Mcare will not provide indemnity coverage or a defense for a claim that is made or occurs if a health care provider, eligible professional corporation, eligible professional association or eligible partnership fails to remit all monies due to Mcare prior to that claim being first reported to the health care provider, the primary insurer or Mcare for the basic insurance coverage period that is applicable to the occurrence that is the basis for the claim (40 P.S. §§ 1303.701, et seq.).
Assessment Rating Manual Information
Mcare has published the Assessment Rating manual for 2020. The assessment percentage remains at 19%.
Please click on the applicable Assessment year below to access the most current Assessment Manual and e-216 reporting form as periodic edits are made to the documents and the site content.
2021| 2020 | 2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009
Mcare e-216 Tools Manual V3.4.pdf
This manual describes the functions of the enhanced e-216 including the Review & Submit tools.
Nonparticipating Transmittal Form e-316 V1.0.5.xlsm
COVID-19 COVERAGE RESOURCES
Volunteer-Temporary or Camp Licenses-Telemedicine during COVID-19.pdf
Nonparticipating Transmittal Form e-316CV V1.0.1.xlsm
Form e-316CV is to be used for reporting nonparticipating COVID-19 volunteers to Mcare. Further information can be found on page 23 of the 2021 Assessment Manual.
PAYMENT OPTIONS
If payment is due, the payment must be sent to Mcare at or about the same time as the e-216 is e-mailed, but within 60 days of the effective date of coverage. When money is due to Mcare, the check, ACH or wire number and payment amount must be included in the Form e-216 and the carrier code must be included on the face of the check or in the designated space of your ACH or wire so we can match the e-216 with the payment. Please make payments payable to: Medical Care Availability and Reduction of Error Fund or "Mcare". Mcare does not accept cash payments.
Setting Up Electronic Payment Assessment payments may be made through an electronic funds transfer ("EFT") payment process. The EFT payment method is an alternative to the check payment method. The EFT may be an ACH or wire transfer. Using the EFT process instead of mailing a check benefits the primary insurers by ensuring that the payment is not delayed in the mail. It also allows Mcare to process the payment in a more efficient manner. To learn more about this payment option and the required minimum standards, please send an e-mail to Mcare's Fiscal Unit at ra-in-mcare-exec-web@pa.gov expressing your interest; an Mcare representative will reach out to explain the program.
If you need to mail a physical check to Mcare, please use one of the following addresses:
Mcare Division of Coverage P.O. Box 12030 Harrisburg, PA 17108-2030
Mcare Division of Coverage 1010 North 7th Street, Suite 201 Harrisburg, PA 17102-1410
Assigned Entity or Group Numbers
For those entities or groups that do not have a unique license number provided by another Commonwealth agency, Mcare has created a unique number to be used when reporting coverage for these entities for statistical purposes. Numbers are assigned by Mcare to identify hospitals ("HS"), corporations ("MC"), or groups ("GP"). If a number for an entity or group is not found on our website, please contact our Coverage Unit.
Birth Center List 12-02-20
Corporation List 12-02-20
Group List 12-02-20
Hospital List 12-02-20
Nursing Home List 12-02-20
Primary Health Center List 12-02-20
REQUEST FOR INSURance VERIFICATION-coverage HISTORY
Request for Insurance Verification-Coverage History Form.pdf
HOSPITAL EXPERIENCE MODIFICATION PROGRAM
For additional information on the Mcare Hospital Experience Modification program, please see the current Mcare Annual Report located under the "Reports and Studies" category found at www.insurance.pa.gov.
Coverage contact INFORMATION
Mcare Form e-216 Remittance Submission
ra-in-remittance@pa.gov
Mcare Coverage Inquiries
ra-in-mcare-policy-web@pa.gov
Mcare EFT Payment (Electronic Funds Transfer)
ra-in-mcare-exec-web@pa.gov
Telephone: (717) 783-3770
Fax: (717) 705-7342
Street Address
1010 N. 7th Street Suite 201
Harrisburg, PA 17102-1400
Post Office Box
PO Box 12030
Harrisburg, PA 17108-2030