Physicians’ Reciprocal Insurers to Present Webinar “How to Respond to Document Requests, Audits and Overpayment Demands”

June 10, 2019 by matray

Physicians' Reciprocal Insurers (PRI) announced an upcoming, June 25, webinar on "How to Respond to Document Requests, Audits and Overpayment Demands."

Presented in partnership with Frier Levitt, a national healthcare law firm, this webinar will provide valuable information for both physicians and practices on how to mitigate the risk of, and respond to audit notices, document requests, and overpayment demands. Knowing what to expect and understanding the best course of action can help protect your professional license, save money, and avoid litigation.

The webinar will be hosted by Guillermo J. Beades, Esq., senior counsel for Frier Levitt's Healthcare Litigation Department. Beades has extensive litigation experience within the healthcare field including litigating before state licensing authorities, federal healthcare agencies and state healthcare agencies.

According to PRI, this webinar will take you through the process of what to do when receiving a request or demand from a government agency or private payor, which will include:

• How to identify if a document request is problematic

• Current audit trends with a focus on the codes, modifiers, and procedures that are a substantial risk for triggering an audit

• How to formulate an action plan to respond to audits and document demands

• How physicians and practices can protect themselves and low lower the risk of adverse audit findings

• Identifying common pitfalls and how to avoid them

This free webinar will take place on Tuesday, June 25, from 2-3 p.m. To register for this event please use this Registration Link.

For additional information, please contact Katherine Guglielmo at KGuglielmo@frierlevitt.com.

A.M. Best Places Credit Ratings of CMIC Group’s Members Under Review With Negative Implications

June 7, 2019 by matray

A.M. Best has placed under review with negative implications the Financial Strength Rating of A- (Excellent) and the Long-Term Issuer Credit Ratings of “a-” of Connecticut Medical Insurance Company (Glastonbury, CT) and its sponsored risk retention group company, CMIC Risk Retention Group (District of Columbia). These companies are referred to collectively as CMIC Group (the group).

The under review status considers several strategic initiatives that management plans to execute during the third quarter of 2019 and the benefits these are expected to have on the group’s prospective operating results. These initiatives, combined with corrective underwriting actions introduced by management in the prior year, are expected to improve the group’s operating performance, which has suffered in recent years due to increased claims severity, diminishing reserve redundancies, and a declining premium base. A.M. Best views these initiatives being taken in the upcoming quarter as material and therefore, failure to execute on these plans is likely to result in negative ratings pressure, hence the negative rating implications. The ratings will remain under review pending further discussions with management and, more importantly, the execution of these new initiatives.

Fitch Downgrades ProAssurance’s HoldCo Ratings; Affirms IFS Ratings at ‘A’

June 6, 2019 by matray

Fitch Ratings has affirmed ProAssurance Corporation’s (PRA) subsidiaries Insurer Financial Strength (IFS) ratings at 'A' (Strong). Fitch has downgraded PRA's senior unsecured debt to 'BBB' from 'BBB+' and its Issuer Default Rating (IDR) to 'BBB+' from 'A-'. The Rating Outlook is Stable. A full list of rating actions follows at the end of the release.

KEY RATING DRIVERS

The rating affirmation considers the company's very strong capital and profitability, low financial leverage, and favorable reserve experience. Partially offsetting these positives is the company's business profile.

Fitch's downgrade of the holding company ratings reflects a financial leverage and fixed-charge coverage ratio profile that is no longer consistent with narrow notching. In particular, narrow notching may be applied if a company maintains 15% or less financial leverage or has 12x or greater in fixed-charge coverage (FCC). As of YE 18, PRA had FLR of 16% and FCC of 5.5x respectively.

While financial leverage has increased, mainly from reductions in common equity from dividends and share repurchases, it was the decline in FCC below a 12x threshold that has led to the holding company ratings being downgraded. FCC declined, for the sixth consecutive year primarily due to the effect of lower prior year favorable reserve development on earnings.

Fitch views PRA's profitability as very strong but declining. The full year calendar year combined ratio for 2018 was 101.5%, up from the prior year's 95.4%. Calendar year combined ratios for the past several years have benefited from large favorable loss reserve development. Pre-tax operating income was $73 million for full year 2018 down 42% from the prior year and 71% from full year 2014.

PRA has a moderate business profile. Approximately 60% of overall premium relates to medical professional liability insurance (MPLI) a relatively volatile line of business. The MPLI market includes numerous monoline MPLI writers that have very strong capital positions and limited underwriting opportunities outside of MPLI, thus intensifying a soft market. The company does actively write workers' compensation but is exploring strategic alternatives for its Lloyd segment.

Overall, reserve adequacy is a positive to the rating. PRA is likely to continue to report significant but declining favorable prior period reserve development going forward. Fitch believes that current loss ratio estimates incorporate a reasonable but conservative view for future claims reserves.

RATING SENSITIVITIES

The following could lead to a downgrade of all ratings:

--An increase in financial leverage above 28% or decline in operating earnings-based coverage below 6x;

--Material adverse reserve development;

--An increase in the company's GAAP operating leverage of 1.0x or higher;

--A Prism capital model score below 'Strong' (currently 'Very Strong').

The following could lead to an upgrade:

--An improvement in business profile while maintaining profitability.

ISMIE Mutual Admitted in Texas

June 6, 2019 by matray

Today, the ISMIE Mutual Insurance Company announced that Texas insurance regulators have approved the company’s rate and forms filing. According to the company, growing its foothold in Texas is a significant step for the medical professional liability carrier’s national expansion.

With this development, ISMIE is able to offer Texas physicians, health professionals and medical entities of all types its customized medical liability coverage. New policyholders will gain access to a wide range of ISMIE’s core products, which include risk management products, cyber liability protection and claims services.

“Obtaining approvals in Texas in 2019 was an important strategic goal for ISMIE,” said Paul H. DeHaan, MD, ISMIE chairman. “We previously established our presence in Texas through our subsidiary ISMIE Indemnity, so we benefit from having an understanding of the Texas market. Being an admitted carrier allows more coverage options for our current and future policyholders.

“Texas hosts a vibrant, innovative and growing medical community. ISMIE offers that community a broad range of risk management and medical liability products. We are working with top-tier, Texas-based distribution partners and expect significant interest to come from the Texas market.”

ProAssurance Announces Results from 2019 Annual Meeting of Shareholders

May 23, 2019 by matray

Shareholders of ProAssurance Corp, acting at yesterday’s Annual Meeting of Shareholders, cast approximately 95 percent of their votes to elect Edward L. Rand, Jr., president and chief operating officer of ProAssurance, to its Board of Directors for a one-year term ending at the Annual Meeting of Shareholders in 2020.

Shareholders also cast 99 percent of their votes to add Maye Head Frei to the Board. She will serve a three-year term ending at the Annual Meeting of Shareholders in 2022. Shareholders voted to re-elect Kedrick D. Adkins, Jr., CPA, Bruce D. Angiolillo, JD, and W. Stancil Starnes, JD, to the Board, with each receiving more than 97 percent of the votes cast by shareholders. They will also serve a three-year term ending at the Annual Meeting of Shareholders in 2022.

Acting on matters related to compensation, ProAssurance shareholders cast approximately 98 percent of their votes to approve, on an advisory basis, the compensation of the company’s named executive officers for 2018. The selection of Ernst & Young, LLP as ProAssurance’s independent auditing firm for the fiscal year ending December 31, 2019, was approved by more than 98 percent of the votes cast by shareholders.

The MPL Association Elects Two New Directors at 2019 Annual Conference

May 22, 2019 by matray

The Medical Professional Liability (MPL) Association, the association representing the medical professional liability insurance community, has announced the election of J. Michael Conerly, MD, LAMMICO, and Gregg L. Hanson, Coverys, to serve three-year terms on the Association’s Board of Directors. The election occurred on May 17, during the Association’s Annual Meeting of Members at the 2019 MPL Association Conference in Portland, Ore.

J. Michael Conerly, MD, is president and chief executive officer of LAMMICO. Conerly is a long-standing member of LAMMICO’s leadership, having served as a member of the Underwriting, Marketing, Joint Risk Assessment, Governance and Audit Committees during the past 22 years. He was elected as chairman of the Board of Directors in 2011 after serving on the Board since 1999. Conerly participated in the MPL Association’s Fellows Leadership Program and served on the Activities Committee and International Section.

Conerly practiced surgery in Alexandria, La., from 1990 to 2018. He was a founding member of Mid-Louisiana Surgical Specialists in 2003, where he was a surgeon and president until 2018. Conerly is certified by the American Board of Surgery and is a fellow of the American College of Surgeons.

Gregg L. Hanson is the chief executive officer and president of Coverys, a position he has held since January 2012. Since joining the company in 2000, Hanson has also served as the company’s chief operating officer, senior vice president of underwriting, and vice president of underwriting. Hanson is currently the chair of the Association’s CEO/COO Section and on the Board of the Political Action Committee, and has participated on the Nominating Committee.

Hanson began his career with the St. Paul Insurance Companies. He is a graduate of the University of North Dakota where he received a Bachelor of Science degree in business administration. He is a member of the American Society of Healthcare Risk Management and the Professional Liability Underwriting Society.

“The MPL Association will be well served by the experience and knowledge of these two leaders,” said MPL Association president and CEO Brian K. Atchinson. “We look forward to working with them both to advance the mission of the organization and its members.”

The MPL Association Board of Directors re-appointed Mary-Lou Misrahy, president and chief executive officer, Physicians Insurance a Mutual Company, to serve as its chair. In addition, James Q. Swift, DDS, chairman, OMS National Insurance Company, was re-appointed as vice chair and John H. Mize, president and CEO, SVMIC, was re-appointed as secretary.

The Hilb Group Acquires Keane Insurance Group

May 22, 2019 by matray

The Hilb Group, LLC, a middle-market insurance agency headquartered in Richmond, Va., and a portfolio company of the private equity firm Abry Partners, announced today the acquisition of Missouri-based The Keane Insurance Group, Inc. The transaction became effective May 1, 2019.

Founded in 1995, The Keane Insurance Group is an insurance brokerage specializing in medical professional liability insurance for physicians and other healthcare providers throughout the nation. Its associates and agency leader, John Keane, are joining The Hilb Group under their existing name and will continue to operate out of their main office in St. Louis, and other locations.

“Our team has significant experience working with doctors and healthcare professionals throughout the nation,” said John Keane. “Joining [The Hilb Group] allows us to continue to exceed client expectations by leveraging size, knowledge, and experience to find the best possible offerings and resources for all of our clients and associates.”

“[The Keane Insurance Group] has a long, established presence in the medical professional liability market,” said Ricky Spiro, THG CEO. “We are excited to add their team’s strong expertise as we continue to grow [The Hilb Group’s] national footprint.”

Pinnacle Actuarial Welcomes Greg Frankowiak as Senior Consulting Actuary

May 21, 2019 by matray

Pinnacle Actuarial Resources announced that Greg Frankowiak, FCAS, MAAA, CPCU, CSPA, MSM, has joined the firm as a senior consulting actuary in the firm’s Bloomington, Ill., office.

Frankowiak has more than 20 years of property and casualty actuarial experience. He holds Bachelor of Arts degrees in Mathematics and Physics from Knox College and a Master’s of Science in Management from The American College. Prior to consulting, Frankowiak worked for a leading primary insurance carrier where he was responsible for the development and execution of predictive analytics strategies as part of its pricing and underwriting functions.

Frankowiak has extensive experience in predictive analytics for both pricing and underwriting, product management and strategy development, underwriting/operations, ratemaking for private passenger automobile and homeowners insurance, regulatory and filing support as well as business intelligence. He is a Fellow of the Casualty Actuarial Society and a Member of the American Academy of Actuaries. He currently serves as a member of the CAS Ratemaking Committee and has spent more than the past decade on several automobile residual market actuarial committees.

“As a leader in predictive analytic applications, Pinnacle is excited to add Greg to the team,” said Roosevelt Mosley, FCAS, MAAA, CSPA, Pinnacle principal and consulting actuary. “Greg’s experience in using predictive analytics to improve business processes will be of significant value as we craft unique solutions for our clients.”

Pinnacle is an independent, full-service actuarial firm focused on the property/casualty insurance industry. Headquartered in Bloomington, Ill., the firm also has offices in Atlanta, Chicago and San Francisco.

Medical Mutual Holdings Inc. Rebrands to Curi

May 21, 2019 by matray

North Carolina-headquartered insurer of medical liability Medical Mutual Holdings, Inc., announced that it is rebranding to Curi, a new name and brand that is intended to better reflect the company’s mission to help physicians in medicine, business and life. According to the company, the Curi name captures the constant curiosity that the company has had since its founding — a curiosity to continually look for new ways to meet the ever-evolving needs of physicians.

A mutual insurance company owned by physicians, Curi has also expanded its offerings beyond medical malpractice insurance to a variety of services for physicians and medical practices, including wealth management and other financial services, health policy consulting and well-being programs.

“The Curi brand is a more accurate reflection of our mission to help physicians in medicine, business and life. It’s a mission we’ve been focused on internally for some time now — it’s been our North Star as we’ve expanded into new offerings and geographies in recent years,” said Dale Jenkins, Curi chief executive. “While many of our practice services have been embedded in the insurance part of our business, offerings like health policy consulting are new to the mix. Our wealth management services for physicians and retirement plan solutions for practices are also newer to our core set of resources for physicians and those who support them.

“We’re continuing to explore the needs and opportunities that aren’t being met for physicians. We’re here to care for the caregivers, and we know that can and will take many shapes in the future. You can expect to see new ideas from us soon.”

The company that became Curi was established as Medical Mutual Insurance Company of North Carolina in 1975, when other carriers stopped offering medical professional liability insurance to physicians in North Carolina. Since then, the company’s insurance offerings have expanded to 46 states and the District of Columbia, with concentrations of customers in the Southeast and Mid-Atlantic regions.

A mutual company owned by physicians, Curi has also expanded its offerings beyond medical malpractice insurance to a variety of services for physicians and medical practices, including wealth management and other financial services, health policy consulting, and well-being programs.

The comprehensive rebrand includes:

• The new Curi name, which points to curiosity, a trait that drives the Curi team forward in pursuit of supporting physicians.

• A new logo (see above) inspired by the company’s legacy and its previous logo. The Curi mark signifies passion and curiosity.

• A brighter color palette that breaks from the traditional greens and blue of the healthcare industry with bright shades that differentiate the company from its peers.

• A more modern digital presence with the launch of three new websites — Curi.com, Curi Practice Services and Curi Capital — each of which represent a more streamlined experience for visitors, returning members and customers.

The Doctors Company Names Daniel Cassavar, MD, to Board of Governors

May 21, 2019 by matray

The Doctors Company announced the appointment of Daniel Kent Cassavar, MD, MBA, to its Board of Governors.

Cassavar most recently was president and chief medical officer of ProMedica Physicians, a healthcare network of specialized hospitals, facilities, researchers, physicians and

advanced practice providers headquartered in Toledo, Ohio, and serving 28 states. ProMedica is renowned for its medical excellence, strong physician culture and commitment to community service. Prior to joining ProMedica, Cassavar was an interventional cardiologist at Northwest Ohio Cardiology Consultants and was a founding member of Cardiocare Consultants.

"We are pleased to welcome Dr. Cassavar to our board," said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company. "His experience as a physician leader with a strong clinical background and remarkable success in leading a 975-provider network will be a wonderful complement to our mission to advance the practice of good medicine."

Cassavar is a diplomate of the American Board of Internal Medicine and certified in interventional cardiology and cardiovascular diseases. He is a fellow of the American College of Physicians and the American College of Cardiology and a member of the American Medical Association, the Toledo and Michigan chapters of the American College of Cardiology, the American Heart Association, the American College of Chest Physicians and the Society of Vascular Medicine.

"I am very proud to be associated with The Doctors Company," said Cassavar. "Its mission and vision, culminating in the enhancement of patient safety, are second to none. It is a true pleasure to assist in the continued strategic growth of this unparalleled organization." After graduating from the Medical College of Ohio, Cassavar completed his residency at St. Mary Medical Center of UCLA, was chief fellow of Cardiovascular Medicine at Providence Hospital and Medical Centers in Michigan, and earned an MBA from the University of Michigan, Ross School of Business.