Key Considerations for Incorporating Arbitration Clauses into Admission Agreements for Long-Term Care Facilities Covered by the Indiana Medical Malpractice Act
By Katie R. Osborne — Attorney
Why This Matters
Long-term care (“LTC”) facilities commonly include arbitration provisions in their admission agreements as an efficient and cost-effective way to resolve legal disputes. However, LTC facilities in Indiana should carefully consider the unique nature of the Indiana Medical Malpractice Act[1] (“MMA”) to avoid the unintentional waiver of provider protections created by the MMA, including the medical review panel process and limitations on damages.
The Medical Malpractice Act
The MMA establishes a framework for handling medical malpractice claims against qualified health care providers in Indiana. Two important protections available to providers via the MMA are the medical review panel requirement and the statutory caps on damages.[2] The MMA requires that, absent written agreement by the parties, a plaintiff must present his or her claim to a medical review panel for its expert opinion before proceeding in state court.[3] A medical review panel’s opinion is admissible as expert evidence at trial and can therefore be a powerful tool to combat meritless claims filed against qualified providers.[4] The MMA also sets statutory caps on the amount which may be recovered from a qualified provider, with the cap dependent on the date of the alleged malpractice.[5]
A broadly worded arbitration agreement, if not drafted with intention, could result in an unintentional waiver of one or both protections. Indiana Courts generally enforce arbitration clauses and, when applied to claims covered by the MMA, have held that a broad arbitration clause which does not include language requiring compliance with the MMA as a condition precedent to arbitration will result in a waiver of the MMA’s provisions, including the medical review panel process and limitations on damages. See Estate of King v. Aperion Care,155 N.E.3d 1193 (Ind. Ct. App. 2020) (holding that a broad arbitration provision included in a LTC admission agreement resulted in a waiver of the MMA’s protections where the provision did not require the MMA procedures as a condition precedent to arbitration).
Key Takeaways
Indiana LTC Facilities can reap the benefits of arbitration clauses while also enjoying the MMA’s protections by carefully drafting arbitration clauses to carve out claims covered by the MMA, for example, by requiring plaintiff to submit a claim to a medical review panel before the claim may be submitted to arbitration or by specifically incorporating the limitations on damages provisions into the arbitration clause.[6] Indiana LTC facilities should carefully review their admission agreements to ensure any arbitration clauses incorporated therein reflect the facility’s intention to participate in or waive the benefits of the MMA.
[1] Ind. Code § 34-18-1-1, et seq.
[2] I.C. §§ 34-18-10; 34-18-14.
[3] I.C. § 34-18-8-5.
[4] I.C. § 34-18-10-23.
[5] I.C. § 34-18-14-3.
[6] See King, 155 N.E.3d at 1197 n.2.
Author Katie R. Osborne
Katie Osborne concentrates her practice in civil litigation. She defends health care providers, including hospitals, physicians, nurses, and long-term care facilities against medical negligence claims and 42 U.S.C. § 1983 claims. Katie has extensive experience defending qualified health care providers, both before the Indiana Department of Insurance and in Indiana State Courts.
In 2024, she and co-counsel secured a defense verdict in favor of their health care provider client following a 9-day jury trial. Katie also skillfully defends health care providers in federal court, securing dismissal and summary judgment where possible. She competently supports her clients through all phases of litigation, from pre-suit investigation through appeal.
Katie engages in client-focused representation and uses a hands-on approach to managing actions with complex factual and legal issues.
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Posted on April 29, 2026, by Katie R. Osborne