What is the New York Medical Indemnity Fund and How Does It Help Families With Birth Injuries?

If your child sustained a severe neurological injury during birth due to medical malpractice in New York, you may have heard about the Medical Indemnity Fund. This state program was designed specifically to help families like yours manage the overwhelming healthcare costs that come with caring for a child with permanent birth-related brain damage.

Understanding how the Medical Indemnity Fund works, what it covers, and whether your family qualifies can make an enormous difference in your child’s access to care and your family’s financial stability.

Understanding the New York Medical Indemnity Fund and Its Purpose

The New York Medical Indemnity Fund (MIF) is a state-run program established in 2011 under Public Health Law Article 29-D. It exists to pay for ongoing healthcare costs for children who suffered birth-related neurological injuries caused by medical malpractice during labor and delivery.

The program serves two main purposes. First and most importantly, it ensures that severely injured children have access to the comprehensive, lifelong medical care they need without families bearing the entire financial burden. Second, it helps stabilize the healthcare system by making malpractice costs more predictable for hospitals and providers.

Think of it as a safety net that catches families after something has gone terribly wrong during childbirth. Rather than receiving a one-time settlement that might run out, families enrolled in the MIF have their qualifying medical expenses paid as they occur throughout the child’s lifetime.

Which Children With Birth Injuries Qualify for the Medical Indemnity Fund?

Not every birth injury qualifies for the Medical Indemnity Fund. The program has specific eligibility requirements that families must meet.

To qualify, a child must have sustained a neurological injury specifically during labor, delivery, resuscitation, or medical services provided during the delivery admission at a New York hospital. The injury must result in either permanent and substantial motor impairment or a developmental disability as defined by New York’s Mental Hygiene Law.

Critically, there must be a finding of medical malpractice. This means a court must determine through litigation or an approved settlement that healthcare providers were negligent and that negligence caused your child’s injury. You cannot simply apply to the Fund on your own. Enrollment happens through a court order as part of a medical malpractice case.

This requirement means that families typically work with a birth injury attorney who can investigate what happened, establish that malpractice occurred, and secure either a settlement or court judgment that includes enrollment in the Medical Indemnity Fund.

What Medical Expenses and Healthcare Costs Does the Fund Cover

One of the most valuable aspects of the Medical Indemnity Fund is its comprehensive approach to coverage. The Fund doesn’t just pay for doctor visits. It covers the full spectrum of healthcare and support services that children with severe neurological injuries need.

The Fund covers:

• Medical and hospital care including specialist appointments and procedures
• Dental care
• Nursing services both in facilities and at home
• Habilitative therapies that help develop skills and abilities
• Custodial care including daily living assistance
• Up to 1,080 hours per year of respite care to give primary caregivers necessary breaks
• Durable medical equipment like wheelchairs, specialized beds, and feeding equipment
• Home modifications such as ramps, bathroom adaptations, and doorway widening
• Vehicle modifications to transport a child with physical disabilities
• Assistive technology and communication devices
• Transportation to and from medical appointments
• Behavioral therapies
• Nutritional therapies and specialized feeding support
• Prescription medications

Recent legislative changes in 2024 added an especially important benefit. The Fund now reimburses certified family members who serve as “complex care assistants” for providing home caregiving and daily living support. This recognizes that many families prefer to care for their children at home and should be compensated for that skilled work.

How the Medical Indemnity Fund Pays Healthcare Providers and Families

Understanding how the Fund calculates and processes payments can help you work with providers and manage expectations.

The Medical Indemnity Fund uses specific formulas to determine how much it pays for services. Generally, it reimburses at the “usual and customary rate,” which is defined as the 80th percentile of all charges for a particular service in your geographic region. If that information isn’t available, the Fund pays 130% of the Medicaid or Medicare rate for that service.

This payment structure means providers generally receive fair market rates, which helps ensure your child has access to quality care and that providers are willing to accept Fund payment.

The Fund works in coordination with other insurance you may have, including Medicaid and Medicare. It typically functions as a secondary payer, covering expenses that other insurance doesn’t pay for. This coordination ensures there are no gaps in coverage while also preventing duplicate payments.

Claims are managed jointly by the New York State Department of Financial Services and the Department of Health, which handle the administrative aspects of reviewing claims, verifying eligibility, and processing payments.

How to Enroll Your Child in the Medical Indemnity Fund After a Birth Injury

The enrollment process for the Medical Indemnity Fund is different from most benefit programs because it’s tied directly to the legal system.

You cannot apply to the Fund independently. Enrollment happens automatically through a court order when you successfully pursue a medical malpractice case related to your child’s birth injury. This order comes either after winning at trial or as part of a negotiated settlement agreement.

This is why working with an experienced birth injury attorney is essential. Your attorney will investigate the circumstances of your child’s injury, gather medical records and expert opinions, file a malpractice lawsuit, and negotiate with the hospital’s or doctor’s insurance company. If malpractice is established and your child meets the Fund’s eligibility criteria, enrollment in the MIF becomes part of the resolution.

Once the court issues an enrollment order, you’ll need to submit medical documentation and other required paperwork to the Fund administrator. This includes records proving your child’s injury, disability status, and ongoing medical needs.

After enrollment is complete, you can begin submitting claims for qualifying healthcare expenses. The Fund will work with your medical providers to pay covered costs as they arise.

Recent Changes and Financial Challenges Facing the Medical Indemnity Fund

The Medical Indemnity Fund has undergone significant changes in recent years, which affects families who depend on it.

The Fund operates on annual appropriations from the New York State Legislature. In recent years, that funding has exceeded $52 million annually. However, as more children have been enrolled and as medical costs have risen, the Fund has faced financial pressure.

In 2024, the Fund’s growing liabilities led to temporary enrollment suspensions until emergency appropriations were passed by the legislature. This created uncertainty for families in the middle of malpractice cases. While the crisis was resolved with additional funding, it highlighted ongoing sustainability concerns.

Between 2021 and 2024, several pieces of legislation expanded and clarified the Fund’s operations. Senate Bill S8956 and Assembly Bill A9566, both passed in 2024, expanded benefits and created the family caregiver reimbursement program. Earlier legislation in 2021 and 2022 made case management services permanent and broadened administrative flexibility.

These changes generally benefit families by expanding what’s covered and how services are delivered. However, they also increase the Fund’s financial obligations, which may lead to future legislative debates about funding levels and eligibility criteria.

Families enrolled in or pursuing enrollment should stay informed about legislative developments that might affect their benefits.

Why the Medical Indemnity Fund Matters for Families Dealing With Birth Injuries

Caring for a child with a severe birth-related neurological injury involves challenges that extend far beyond the immediate medical crisis. The ongoing costs of specialized care, equipment, therapies, and modifications can easily reach into the millions of dollars over a lifetime.

The Medical Indemnity Fund provides something invaluable that a traditional settlement often cannot: guaranteed, ongoing payment for healthcare needs as they arise. Rather than managing a settlement fund that might be depleted by unexpected medical crises or simply by the passage of time, families enrolled in the MIF have assurance that qualifying medical expenses will be covered.

This structure allows families to focus more on their child’s wellbeing and development rather than constantly worrying about healthcare budgets. It means you can say yes to a therapy that might help, pursue a surgical option recommended by specialists, or modify your home to improve your child’s quality of life without calculating whether you can afford it.

The program also acknowledges an important reality: when medical negligence causes devastating injury, the responsible parties should cover the resulting costs. The Fund creates a mechanism for this that’s more stable and sustainable than traditional lawsuit settlements.

Finding Legal Help to Access the Medical Indemnity Fund

Because enrollment in the Medical Indemnity Fund only happens through the medical malpractice legal process, connecting with the right attorney is your first step toward accessing these benefits.

Look for a lawyer who specifically focuses on birth injuries and medical malpractice in New York. This area of law requires deep understanding of both complex medical issues and New York’s specific legal requirements. The attorney should have experience not just with malpractice cases generally, but specifically with cases involving neurological birth injuries and Medical Indemnity Fund enrollment.

During initial consultations, ask about the attorney’s experience with the MIF, how many clients they’ve successfully enrolled, and their understanding of the Fund’s current status and recent legislative changes. The right attorney will be familiar with the medical experts needed to prove birth injury cases and will understand the specific documentation required for Fund enrollment.

Most birth injury attorneys work on a contingency basis, meaning they don’t charge upfront fees and only get paid if they recover compensation for your family. This arrangement makes experienced legal representation accessible even when families are already facing financial stress from medical expenses.

The legal process takes time, often years from filing through resolution. But for families of children with severe birth-related neurological injuries, successfully accessing the Medical Indemnity Fund can provide security and comprehensive care coverage for your child’s entire lifetime.

Understanding your options and taking action to protect your child’s access to necessary care is one of the most important things you can do in the difficult period following a birth injury.