Mcare Refund Notice Letters Mailed – Next Steps for Pennsylvania Physicians

On Nov. 16, 2015, Mcare mailed to physicians and medical practices notice letters with information about assessment refunds for their Mcare coverage. The refunds are required by a settlement agreement for litigation in which the Pennsylvania Medical Society (PAMED), The Hospital and Healthsystem Association of Pennsylvania, and the Pennsylvania Podiatric Medical Association challenged how Mcare calculated its annual assessments and diversion of Mcare funds by the Commonwealth.

If you paid an Mcare assessment (or an assessment was paid for you) for 2009, 2010, 2011, 2012, or 2014, refunds will be made for your coverage and you would have been mailed a notice letter. Medical practices also would have been mailed a notice letter if they paid an assessment for Mcare coverage in any of those years.

The notice letter was mailed in a #10 business envelope with double windows for the Mcare return address and your name and address.  If your mail is handled by administrative staff, you should advise them to direct your notice letter to your immediate attention and to not open the envelope, as it contains confidential, time-sensitive information.

Be sure to retain your notice letter. You will need information in that letter to take next steps described below and to verify that any refunds for your coverage have been correctly paid. You will also need this information if you have to contact Mcare about the refunds for your coverage.

Next steps for physicians

A notice letter enclosure provides an itemization of each refund for your coverage. Any next steps that you must take to ensure proper payment of the refunds for your coverage depend upon the designation of your refund in the second column of your refund itemization.


Designation of refund

Next steps

Timeline for action

Claimed Go to to choose who Mcare should pay – you or the claimant; Mcare will honor your choice. Endeavor to make your payment choices for claimed refunds by Dec. 30, 2015.
Assigned No further action is required; Mcare will pay the refund to the assignee. Reach out to the listed assignee ASAP if you dispute a listed assignment; contact Mcare only if this does not resolve the dispute.
Blank (no designation) No further action is required; Mcare will automatically pay the refund to you unless you subsequently assign the refund.* Endeavor to complete any assignments by Dec. 30, 2015.

*When a medical practice is owed a refund payment for the coverage of the practice entity, Mcare needs the practice’s Tax ID number before it can make any payment to the practice. The practice’s notice letter will include a form for the practice to provide its Tax ID number if Mcare does not already have this information. The requirement for a Tax ID number does not apply to physicians.

Payment of refunds

If any refunds are payable to you, you can expect your check in the first quarter of 2016, unless you have one or more claimed refunds and you fail to make payment choices for all of your claimed refunds on the McareChoice website by Dec. 30, 2015.

Failure to make payment choices for all claimed refunds by that cut-off date will delay your payment until the second quarter of 2016 when Mcare makes the final round of payments. This payment delay will apply to all of your refunds, including those that will be automatically paid to you because they have been neither claimed nor assigned.

Your refund check will be mailed to the same address where your notice letter was successfully delivered unless you update your mailing address in the interim. However, Mcare will not mail a refund check to you if your refund notice is returned to Mcare as undeliverable.

Additional information on refund process

PAMED’s website – – includes further information on the Mcare settlement including the refund process. Resources available include:

  • Quick Consult on the Mcare Refund Notice Letter, which provides further details on next steps to ensure that refunds for your coverage are properly paid
  • Quick Consult on Legal Issues Impacting Mcare Refund Assignment and Claim Decisions, which provides information to help you determine whether it is in your best interest to agree to payment of a claimed refund to the claimant or to assign an unclaimed refund
  • Video on the McareChoice website, which walks you through the steps of making a payment choice on a claimed refund

Watch for updates in PAMED’s Daily Dose email to members and at