Augment medical liability based on the percentage of Medicare, Medicaid, and uninsured patients the practice cares for.
If the percentage of payors in a physician's practice is greater than 25 percent Medicare, Medicaid, or uninsured that physician should be considered a "federal employee" under the Federal Tort Claims Act . The physician would be subject to the protections that the Federal Tort Claims Act affords physicians employed at federal institutions. The percentage would have to be averaged over a specific amount of time and would be specific to the physician. This would encourage individual physicians to compete for a certain percentage of Medicare, Medicaid, and uninsured patients. The percentages would be calculated at the end of a specific time period, e.g. three years, and applied to the care delivered over the antecedent period (the previous three years). There would have to be a grace period if the physician's payor mix dropped below the percentage so that the physician could work to increase the percentage of Medicare, Medicaid, or uninsured patients. There would have to be a tail insurance product that physicians can purchase if their practice changes. More specific details would have to be crafted if the idea gained interest. The idea being that federal protections would "subsidize" physicians by lowering malpractice insurance premiums. This would also increase the competition for such payors improving access to medical care.
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