Federal Tort Claims Act (FTCA) Coverage

for Individuals at Free Clinics

Technical Assistance CallPAL 2011-09Department of Health and Human Services

(HHS)Health Resources and Services Administration

(HRSA)Bureau of Primary Health Care (BPHC)

Office of Quality & Data (OQD)August 16, 2011

2

Today’s Call

I. PurposeII. Overview of FTCA CoverageIII. Requirements for Free Clinic FTCA

CoverageIV. Eligible IndividualsV. Revised ApplicationVI. Dates and Important InformationVII.Resources and Contact Information

3

II. Overview ofFTCA Coverage

• Established by Section 194 of HIPAA adding section 224(o) of the Public Health Service Act, covering volunteer health professionals

• Expanded by the Affordable Care Act in 2010 to include board members, officers, employees, and individual contractors

4

II. Overview of FTCA Coverage

• Provides Medical Malpractice Coverage for deemed individuals providing medical, surgical, or dental services

• Eligible Individuals must be sponsored by a Free Clinic

• Free Clinic entity is NOT covered by FTCA

• NOT general liability coverage

5

• FTCA coverage is similar to an occurrence policy – coverage is for any incidents that occur during time the individual is covered under FTCA

• No specific coverage limit• Punitive damages not allowed • Cases defended by the United

States in Federal court

II. Overview of FTCA Coverage

6

III. Requirements

• Must be a nonprofit organization• Cannot accept third party

reimbursement• May not impose charges on patients • May accept donations • Are licensed or certified in

accordance with applicable state law

Sponsoring Clinics:

7

III. Requirements

Major Requirements for Deeming:

• Credentialing and Privileging System• Risk Management System• Patient Notification of Limited Liability• Medical Malpractice Claims Review• Data Reporting

8

III. Requirements

Risk Management• Quality Improvement/Quality

Assurance Plan (QI/QA Plan)• Identifies Free Clinic’s plan to mitigate

risk and improve quality care for patients• Should map out plan for identification and

evaluation of concerns, education plan for staff members, and responsibilities of management

• Also include Free Clinic’s credentialing and privileging processes

9

III. Requirements

Review of Medical Malpractice Claims• Used to ensure appropriate policies and

procedures are in place to reduce risk of medical malpractice

• Report any medical malpractice claim or disciplinary action taken by licensing board• Report for past ten years for new applicants• Report from past five years for renewal

applicants

10

III. Requirements

Annual Data Reporting• Occurs the first quarter of each year• Examples of information requested:• Number of visits per clinic by covered

individuals• Number of patients per clinic by covered

individuals

11

IV. Eligible Individuals

Eligible Individuals:• Volunteer Health Professionals• Board Members• Officers• Employees• Individual Contractors • Must have individual contract

between individual and clinic

12

V. Application

• New Application now in Excel

• Can save application in progress unlike previous fillable PDF

• Email entire application IN EXCEL to freeclinicsFTCA@hrsa.gov

13

V. Application

• Each section of application has its own “worksheet”

• Five worksheets in total• Click tabs on bottom of page to move

between worksheets

14

V. Application

First Worksheet:Contact Information• Free Clinic

organizational information

• FTCA Contact Person(s)

• Free Clinic Sites• Update sites or

address here

15

V. Application

Second Worksheet:

Sponsoring FreeClinic• Confirm

eligibility • Click button for

“yes” or “no”• Explain all “no”

answers

16

V. Application

Third Worksheet:Credentialing andPrivileging • Answer questions

regarding credentialing and privileging processes

• Click “yes” or “no”• Explain all “no”

answers

17

V. Application

Fourth Worksheet:Risk ManagementSystems• Answer questions

about Risk Management and QI/QA plan

• Also attach QI/QA Plan WITH board signature

• Explain all “no” answers

18

V. Application

Fifth Worksheet:Individuals’ Information• List name of EACH

individual seeking deeming status• Including board

members, officers, employees, and contractors

• HRSA will only consider those listed on the application

19

V. Application

Fifth Worksheet: Individuals’ Information (continued)

• Credentialing and Privileging should be done every two (2) years

• Credentialing/Privileging date listed should be the date conducted by your organization (or CVO)

• Answer “yes” or “no” if there has been a medical malpractice or disciplinary action against any individual

• Attach explanation of all claims

20

V. Application

Adding more fields• If more lines

needed for people, sites, etc.

• Highlight rows (click on numbers on left)

• Right Click• Choose “Insert”• Repeat as

necessary

21

• Important Information• Send one (1) email. Email should include

EXCEL application form, QI/QA Plan, an explanation of medical malpractice claims, and signature page. Include FC number

• QI/QA Plan must be signed and dated by an authorized member of the board indicating approval

• Please do not have hidden cells on individuals spreadsheet. It interferes with the synching of our database

• Include ALL individuals

V. Application

22

VI. Dates and Important Information

• Deeming Applications due September 16, 2011 for 2012 coverage

• Include all renewals and new individuals on application form. Please do not attach separate spreadsheet

• Board members and officers do not need same credentialing/privileging as providers

• Use renewal application to update sites

23

Questions?

Questions and Answers

Thank you for your continued interest in our programs

24

VII. Resources and Contact Information

For more information on the Free Clinic deeming application or FTCA coverage, please contact the Bureau of Primary Health Care (BPHC)

• 877-974-BPHC (877-974-2742)• The Helpline is available 8:30 AM to 5:00

PM (ET) business days• FreeclinicsFTCA@hrsa.gov• http://bphc.hrsa.gov/ftca/freeclinics/