HCS/SCS/SBs 905 & 910 - This act modifies various provisions relating to medical malpractice insurance and the enforcement powers of the Department of Insurance with respect to such policies. 383 ASSOCIATION ASSESSMENTS - This act provides that 383 malpractice associations articles of association and bylaws shall specify and define the types of assessments its members pay to cover losses and expenses incurred by the association. The articles of association and bylaws shall also specify the type of assessments that apply to members and former members. The act also provides that the articles of association and bylaws shall specify the exact method by which assessment amounts are determined, the time assessments must be paid, and other criteria (section 383.016). 383 MALPRACTICE ASSOCIATIONS - This act subjects 383 malpractice associations to the medical malpractice reporting requirements of Sections 383.100 to 383.125 and subjects such organizations to certain notification, data reporting and rating requirements (Section 383.035). FILING OF INFORMATION BY MEDICAL MALPRACTICE INSURANCE COMPANIES - This act modifies the definition of "insurer" to include 383 medical malpractice associations and self-insured health care providers for the purposes of filing medical malpractice claim reports (Section 383.105). The act requires the director of the Department of Insurance to establish by rule reporting standards in which insurers shall report annually insurance premiums, losses, exposure, and other information the director may require. This data will assist the department to monitor marketplace rates, financial solvency, affordability and the availability of medical malpractice insurance. The data collected shall be compiled in such a manner to assist medical malpractice insurers in developing future base rates, schedule rating or individual rating factors. The act requires the director to establish risk-reporting categories for medical malpractice insurance and establish regulations for the reporting of all base rates and premiums charged by such categories. These risk-reporting categories shall be established prior to May 30, 2007. Beginning June 1, 2008, medical malpractice insurers and self-insured health care providers must provide an annual report describing the actual rates or assessments charged for insurance for each of the risk-reporting categories (Section 383.106). Many of the medical malpractice reporting provisions can be found in the truly agreed to version of HB 1837 (2006). PUBLISHING OF MARKET RATES - The act requires the director to establish and publish market rates using the data collected under the act. The market rate shall reflect the median of the actual rates charged by insurers (those who have at least a 3% market share) for the various risk-reporting categories for the preceding year (Section 383.107). The director shall, utilizing the information provided by Section 383.106, publish comparisons of the base rates charged by each insurer (Section 383.108). PENALTIES FOR NOT FILING OR REPORTING INFORMATION - If an insurer violates any of the provisions relating to reporting medical malpractice information, the director may issue administrative orders and seek other remedies outlined in the act to assure compliance (Section 383.124). RATE FILING - Under this act, every insurer shall file with the director all rates and supplementary rate information which is to be used in the state. Such rates and supplementary rate information shall be filed before use. All rates and supplementary rate information shall, as soon as filed, be open to public inspection at any reasonable time (section 383.196). MEDICAL MALPRACTICE RATES - Under the act, medical malpractice insurers are prohibited from issuing and selling policies that have base rates that are excessive, inadequate, or unfairly discriminatory. The act delineates a multitude of factors that the director will use to determine whether a rate is excessive, inadequate, or unfairly discriminatory. Rates will be based upon Missouri loss experience only, not experience from other states unless the failure to do so will jeopardize the financial stability of the insurer. Investment income and losses for the insurer's previous ten-year period may also be considered. The act allows insurers to charge an additional premium surcharge or discount based on the health care provider's loss experience, training, and other factors (Section 383.198). NOTICE PRIOR TO INCREASING RATES, REFUSAL TO RENEW POLICIES OR CEASING BUSINESS - The act prohibits medical malpractice insurers from increasing rates by more than 15% without providing at least 60 days written notice to the insured (section 383.199). The act prohibits medical malpractice insurers from refusing to renew a policy without providing 60 days written notice. The act also prohibits medical malpractice insurers from ceasing the issuance of such policies without first providing at least 180 days notice to the Department of Insurance (Section 383.450). STEPHEN WITTE