The New Jersey Medical Care Access and Responsibility and Patients First Act (Act), P.L. 2004, c.17, was signed into law on June 7, 2004. The Act creates the Medical Malpractice Liability Insurance Premium Assistance Fund; the Health Care Subsidy Fund; a student loan reimbursement program for obstetrician/gynecologists; and an annual allocation to the Division of Medical Assistance and Health Services. The Medical Malpractice Liability Insurance Premium Assistance Fund is to be administered by the Department of Banking and Insurance (see N.J.S.A. 17:30D-28 et seq.).

The Medical Malpractice Liability Insurance Premium Assistance Fund (Fund) was created for the purpose of preserving access to quality medical care for New Jersey patients by providing direct relief towards the payment of medical malpractice liability insurance premiums to certain health care providers in New Jersey, who are finding it difficult to remain in practice due to escalating medical malpractice liability insurance premium rates.

Revenue for the Fund is being collected from the following sources:

• An annual surcharge of $3 per employee for all employers who are subject to the New Jersey "unemployment compensation law," collected by the comptroller for the New Jersey Unemployment Compensation Fund and paid over to the State Treasurer for deposit in the Fund annually, as provided by the commissioner, which surcharge may, at the option of the employer, be treated as a payroll deduction to each covered employee;
• An annual charge of $75 to be imposed by the State Board of Medical Examiners on every physician and podiatrist licensed by the board pursuant to the provisions of R.S.45:9-1 et seq., collected by the board and remitted to the State Treasurer for deposit into the Fund;
• An annual charge of $75 to be imposed by the State Board of Chiropractic Examiners on every chiropractor licensed by the board pursuant to the provisions of P.L.1989, c. 153 (C.45:9-41.17 et seq.), collected by the board and remitted to the State Treasurer for deposit into the Fund;
• An annual charge of $75 to be imposed by the New Jersey State Board of Dentistry on every dentist licensed pursuant to the provisions of R.S.45:6-1 et seq., collected by the board and remitted to the State Treasurer for deposit into the Fund;
• An annual charge of $75 to be imposed by the New Jersey State Board of Optometrists on every optometrist licensed by the board pursuant to the provisions of R.S.45:12-1 et seq., collected by the board and remitted to the State Treasurer for deposit into the Fund; and
• An annual fee of $75 to be assessed by the State Treasurer and payable by each person licensed to practice law in this State, for deposit into the Fund.

Four health care boards within the New Jersey Division of Consumer Affairs have been given the responsibility to assess and collect an annual fee of $75 over three years (2004 through 2006) from the following licensees: physicians (M.D.s and D.O.s), podiatrists, optometrists, dentists and chiropractors. Certain licensees are automatically exempt if they:

• Have been licensed for less than one year;
• Are barred from practicing by any disciplinary order of the Board or because their license has expired; and
• Are completely retired from practice of their profession and have elected to place their licenses in an inactive status.

For the purposes of this section, "completely retired" means a licensure status established by a licensee's affirmative election of an inactive status at the time of license renewal pursuant to N.J.S.A. 45:1-7.3, or through a submission of other written notice, where authorized by the professional practice act to obtain a certificate of retirement. During the time that a licensee is "completely retired," no practice of the profession, within the meaning of this definition, is authorized, including but not limited to, the prescribing of medications, if authorized within the scope of practice. Physicians who are 65 years old or older, without hospital or health maintenance organization affiliation, and who hold a reduced fee license, issued pursuant to N.J.S.A. 45:9-19.16, shall be deemed active licensees and shall not be deemed "completely retired.

All other licensees will receive a mailing each year in November, with an invoice requiring payment within 30 days. Some additional licensees may be exempt from having to make payment to this Fund. In order to claim an exemption, a licensee will have to complete, sign and return the coupon/invoice attesting that they:

• Are currently on full-time duty with any branch of the armed forces, VISTA or the Peace Corps, and are not required to maintain a New Jersey license to perform their duties, if they are serving within New Jersey; or
• Do not maintain a bona fide office or other practice location at which they engage in or provide services for which a license is required by statute or by virtue of the job description, specifications or qualifications.

For the purposes of this section, "bona fide office" means a practice location at which a licensee engages in any activity or provides any service for which possession of a license is statutorily required or otherwise mandated by virtue of the job description, specifications or qualifications. A "bona fide office" shall include a private practice setting, at a hospital, educational institution, research facility, governmental agency or a business. The accessibility of a licensee at the practice location to members of the public in person, or by telephone, shall not be a determinative factor.

If a licensee fails to pay the required fee or claim an exemption, enforcement and/or collection actions may be pursued. Furthermore, failure to remit payment by the due date will result in the licensee being ineligible for a subsidy from this Fund.

Although the Division of Consumer Affairs is collecting the funds from its licensees, the Department of Banking and Insurance will administer the fund's monies. Please check the Department of Banking and Insurance Web site at: www.njdobi.org for additional information.