Currently, eight states (Indiana, Kansas, Louisiana, Nebraska, New Mexico, Pennsylvania, South Carolina and Wisconsin) have statutorily established entities commonly referred to as patient compensation funds. These funds are designed to improve access to medical care by helping to stabilize volatility in the cost of medical malpractice claims and medical malpractice insurance. In these fund states, eligible HCPs can participate in the PCF (some states have mandatory participation) by maintaining specified primary insurance limits and paying a required fee or premium surcharge. Participating HCPs obtain a second layer of insurance coverage (similar to excess coverage) above and beyond specified primary insurance limits, as well as other statutory benefits in some cases (such as a hard cap on damages and mandatory pre-litigation claim review procedures). For example, a participating Indiana HCP can purchase a $250,000 per occurrence/$750,000 aggregate primary layer of coverage from an admitted carrier and pay the required surcharge. Before a patient can file a malpractice lawsuit against the HCP, the patient must submit the claim to a claims review process that requires three physicians to evaluate the HCP’s culpability. Only after that review is completed can the patient pursue litigation. If such litigation results in a verdict above $250,000, Indiana’s PCF would provide coverage up to the current statutory cap of $1,250,000. Any damages beyond this hard cap are not collectible. Many carriers in these eight states will not insure eligible HCPs unless they participate in the patient compensation fund.