Free Clinics Federal Tort Claims Act (FTCA) Program Requirements and Best Practices

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1 Free Clinics Federal Tort Claims Act (FTCA) Program Requirements and Best Practices May 4, 2018 Kathleen McAndrews, MHA Office of Quality Improvement (OQI) Health Resources and Services Administration (HRSA)

2 Overview Program & Application Requirements The Credentialing & Privileging Requirement Technical Assistance Resources Important Dates Questions/Answers 2

3 Free Clinics FTCA Program The Free Clinics FTCA Program extends free medical malpractice liability coverage to individuals who: Meet program and statutory requirements; and Are deemed as federal employees for such purposes. Individuals in the following categories may be eligible for the Free Clinics FTCA Program: Volunteer health care professionals; Officers; Governing board members; Employees; and Contractors. 3

4 Program Requirements Sponsoring Free Clinics A free clinic must meet and maintain the following program requirements: Quality Improvement/Quality Assurance (QI/QA) Plan, including risk management system; Review of Medical Malpractice Claims & Professional liability patient notice of limited liability; Annual data reporting; and Credentialing and privileging system. 4

5 Free Clinics FTCA Program Map United States Map of Over 200 Participating Free Clinics across 39 states. 5

6 Program Requirements An eligible free clinic must be operated by a non-profit, private entity that: Does not accept reimbursement from any third party payer; Does not impose charges on patients; and Is licensed or certified per applicable law to provide health services. Free Clinics may accept patients voluntary donations. 6

7 FAQ #1 My clinic receives grant funding and donations. Does that make us ineligible for the program? 7

8 FAQ #1 Answer A free clinic can receive grant funding and donations as long as the funding and donations are not for a specific service per person (per capita). 8

9 Program Requirements (Continued) Eligible healthcare professionals such as volunteers, board members, officers, employees, and/or individual contractor(s): Must be sponsored by an eligible free clinic; Must meet all statutory and program requirements; and Provide a qualifying health service (i.e., any medical assistance required or authorized to be provided under Title XIX of the Social Security Act (42 U.S.C. 1396,et seq.). Clinicians must provide services to patients at the free clinic or through certain qualifying offsite events conducted by the free clinic. 9

10 Program Requirements Eligible healthcare professionals must also provide patients with written notification of limited legal liability (if not provided by the free clinic). Individuals who are volunteer health care professionals must be appropriately licensed or certified to provide qualifying healthcare services. 10

11 Service Contracts An individual (contractor) health professional must have a contract directly with the free clinic. A contract between a free clinic and a corporation does not provide sufficient basis for deemed status under the Free Clinics FTCA Program. 11

12 Coverage Approval Coverage is only for medical malpractice claims, specifically medical, surgical, dental, and related functions. Medical malpractice coverage under the Free Clinics FTCA Program does not occur automatically. FTCA coverage requires HRSA s approval of applications for deeming of certain individuals from the sponsoring free clinic. FTCA coverage is not retroactive and is not effective until the date shown on your deeming letter. Free clinic coverage does not extend to free clinic entities. 12

13 FAQ #2 Are there a minimum number of days for volunteers in order to qualify for the program? 13

14 FAQ #2 Answer Volunteers do not have a requirement for a minimum amount of hours in order to qualify for the program. 14

15 Policy Information Notice (PIN) Section V. Program Requirements, A. Credentialing and Privileging Licensed and/or Certified Individuals Primary & Secondary Source Verification Credentialing & Privileging: Licensed Independent Practitioners Other Licensed or Certified Practitioners 15

16 FAQ #3 How do I demonstrate that my free clinic is compliant with the Free Clinics FTCA Program s credentialing and privileging requirements? 16

17 FAQ #3 Answer Each application requests that you affirm or otherwise provide information regarding your free clinic s credentialing and privileging policies and procedures. Updated application questions will be available in the next PAL to be released. 17

18 Types of Applications Initial Application Accepted on a rolling basis throughout the year as long as the EHB System is open to accept applications. Supplemental Application Accepted on a rolling basis throughout the year as long as the EHB System is open to accept applications. Annual Redeeming Application For coverage during CY 2019 (January 1, 2019 to December 31, 2019). System Open to Accept Applications ~August All applications due ~September

19 CY 2019 Requirement Highlights Evidence that each licensed or certified individual was credentialed and privileged by the sponsoring free clinic within the last two years, including the specific dates such actions were taken. Free Clinic Individuals Credentialing and Privileging Date of Last Credentialing Date of Last Privileging Please remember that all state licensed or certified health professionals need to be credentialed and privileged every two years. 19

20 Application Reminders Review PIN to ensure that you are credentialing and privileging individuals according to program requirements. Do NOT submit the National Practitioner Data Bank (NPDB) report. Include credentialing & privileging within the QI/QA plan. Ensure that all licensed or certified health professionals are credentialed and privileged every two years. 20

21 FAQ #4 How do we complete and submit our application? 21

22 FAQ #4 Answer Applications must be completed and submitted through HRSA s EHB, the electronic deeming system. If you are a free clinic applying for coverage for the first time as an initial applicant, you must obtain a DUNS number and register with SAM.gov. 22

23 Resources - Program Website: Free Clinics FTCA Program Website Archived Webinars Policy Documents: Program Assistance Letter (PAL ), Policy Information Notice (PIN ) Application Process Credentialing & Privileging Guide Cover Page of the Credentialing & Privileging Guide 23

24 Resources - ECRI ECRI: Clinical Risk Management Resources Risk management services provided on behalf of HRSA Services provided at no cost to free clinics, health centers, and look-alikes Free Clinics Demonstration Video Credentialing & Privileging Toolkit Cover of the ECRI Demonstration Video 24

25 Important Dates August September 2018: Redeeming Cycle November 30, 2018: Anticipate All Deeming Letters Sent January 1, 2019: New Deeming Coverage Begins 25

26 Contact Us Phone: BPHC Help Line BPHC ( ), select option 2 8:00 AM to 5:00 PM (ET) Online: Contact Form: BPHC Helpline Online Contact Form 26

27 Questions 27

28 Thank You! 28

29 Contact Information Kathleen McAndrews Public Health Analyst, Office of Quality Improvement Health Resources and Services Administration (HRSA) Phone:

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