DEEMING REQUIREMENTS AND APPLICATION PROCESS FOR FTCA MEDICAL MALPRACTICE COVERAGE

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DEEMING REQUIREMENTS AND APPLICATION PROCESS FOR
FTCA MEDICAL MALPRACTICE COVERAGE

• Health Resources and Services Administration
• Bureau of Primary Health Care
• Office of Quality and Data

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Todays Call

1. Purpose
2. Program Updates
3. Types of Applications
4. New Application Requirements
5. Existing Application Requirements
6. FTCA Module in EHB
7. Sub-Recipient Applications
8. Paper Waiver Request
9. Resources

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Purpose

• To provide information on Federal Tort Claims Act
  (FTCA) initial and redeeming application
  processes and requirements
• To review Program Assistance Letter (PAL)
  20011-05 New Requirements for Medical
  Malpractice Coverage Deeming under the Federally
  Supported Health Centers Assistance Act for
  Calendar Year 2012 http//bphc.hrsa.gov/policiesr
  egulations/policies/pal201105.pdf

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Purpose (continued)

• General Program Information Requirements
• Applicants must be a Section 330 organization
• Applicants must be currently funded under the
  Health Center Program
• Health centers must reapply each year for deeming
  status using the EHB FTCA Module

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Program Updates

• FTCA Branch
• New branch within OQD
• 10 staff members
• Focus on FTCA policies, procedures, and program
  development for Health Centers and Free Clinics
• New FTCA Website
• http//www.bphc.hrsa.gov/ftca/
• FTCA Policy Manual (PIN 2011-01)
• http//bphc.hrsa.gov/policiesregulations/policies/
  pdfs/pin201101manual.pdf

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Program Updates(Continued)

• Focus on implementation
• Creation of policies and procedures
• Implementation of policies and procedures
• Reevaluation of policies and procedures
• Site Visits
• Education
• Technical Assistance
• Verification of Implementation

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Types of Applications

• There are two types of applications for FTCA
  coverage
• INITIAL DEEMING APPLICATION
• May be submitted at any time during the year
  using the EHB FTCA Module
• Will be acted upon by HRSA within 30 days after
  receipt of a completed application
• ANNUAL REDEEMING APPLICATION
• All currently deemed health centers must file a
  renewal deeming application no later than July
  11, 2011 in order to be deemed for CY 2012

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New Application Requirements

• Minutes from last six QI/QA committee meetings
• Remove patient names and other identifiers
• Minutes from the last six Board meetings that
  reflect Board approval of QI/QA activities
• Remove all information not related to QI/QA
  activity
• Board-approved Credentialing and Privileging
  policies
• Must be signed and dated by the Board

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New Application Requirements(continued)

• Clinical policies and procedures for the
  following activities
• Referral Tracking
• Hospitalization Tracking
• X-Ray Tracking
• Lab Result Tracking

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Additional Application Requirements

• A complete initial or redeeming application must
  include
• An Application Form completed in EHB
• An approved Quality Improvement/Quality Assurance
  Plan, including governing board signature and
  approval date
• Summary of professional liability history for
  cases filed or closed within the last 5 years, if
  applicable
• Name of provider(s) involved
• Area of practice/Specialty
• Date of Occurrence
• Summary of allegations
• Status and outcome of claim

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Additional Application Requirements (continued)

• A complete initial or redeeming application must
  include
• Explanation of any NO responses
• Deeming applications for any sub-recipients (as
  documented on the organizations most recent
  approved scope from FORM 5B - see sub-recipient
  submission instructions.)

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Additional Application Requirements (continued)

• Credentialing list (in an Excel spreadsheet) of
  all licensed and/or certified health care
  personnel employed and/or contracted by the
  health center, with the following information
• Name Professional Designation (e.g., MD/DO, RN,
  CNM, DDS)
• Title/Position
• Specialty
• Employment Status (full-time employee, part-time
  employee, contractor, volunteer)
• Date of Hire
• Initial Credentialing Date (the first time the
  individual was credentialed by your organization)
• Most Recent Credentialing Date
• Next Expected Credentialing Date

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Application Requirements (continued)

• Incomplete applications will not be processed
  until all components are submitted through the
  EHB FTCA Module
• Application review can not be completed
• Deeming decision can not be finalized
• Deeming Notification Letter may be delayed
• Checklist
• A comprehensive application checklist is included
  in the PAL and should be utilized to ensure
  completion

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FTCA Module in EHB

• Accessing the FTCA Module
• Users are required to navigate to the section 330
  grant portfolio in EHB to access, and begin
  working on the FTCA application

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FTCA Module in EHB (continued)

• Accessing the FTCA Module
• The current section 330 grant project director
  (PD) will be given default access to read,
  complete, edit, and submit the application
• The PD can provide access to the relevant members
  of the organization to enable them to work on the
  FTCA application
• New users must register with EHB before access to
  the application can be provided

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FTCA Module in EHB (continued)

• Accessing the FTCA Module
• Click Work on My FTCA Application
• To create an application, click the Go button
• To return to an application in progress, click
  Edit Application

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FTCA Module in EHB (continued)

• Begin Application Data Entry
• The system will label the organizations FTCA
  application as Initial or Redeeming based on
  the grantees current deeming status
• If you believe your application is incorrectly
  labeled, you can change the system default (e.g.,
  from Initial to Redeeming)
• You must provide an explanation for the change

06/01/11
17
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FTCA Module in EHB (continued)

• Application Data Entry (continued)
• Each grantee must complete all the sections of
  the application
• Each section requires users to provide both
  structured and unstructured (attachments)
  information
• The system has many validation and business rules
  included in each section to ensure that all the
  relevant data elements are populated in the system

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FTCA Module in EHB (continued)

• Application Data Entry (continued)
• The system does not validate the content of the
  attachments that are uploadedgrantees are
  expected to upload and submit the correct
  attachments based on the PAL 2011-05
• The system will mark each section as complete
  when all the requirements and validations for
  that section are met. A user can submit the
  application when all sections are marked as
  complete.

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FTCA Module in EHB (continued)

• Application Data Entry (continued)
• The system is closely integrated with the grantee
  scope data and will pre-populate grantee profile
  information based on the latest information
  available in the EHB system

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FTCA Module in EHB (continued)

• Application Data Entry (continued)
• The system will allow users to
• View the latest approved grant scope (Forms 5A,
  5B, 5C)
• Select contact information from a list of
  existing contacts or provide new/updated contact
  information for the deeming application
• Easily access programmatic resources like the
  PAL, FAQs on the BPHC home page, and the FTCA
  system user guide

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Sub-Recipient Applications

• Grantees with Sub-recipients
• The system will identify existing sub-recipient
  organization data based on the information
  provided by grantees on the approved scope of
  project (Form 5B).
• The system will display the sub-recipient section
  in EHB only if the grantee has identified one or
  more sub-recipients on their current Form 5B.
• The system will validate the grantee scope at the
  time of application submission.

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Sub-Recipient Applications (continued)

• Grantees with Sub-recipients
• Health centers must indicate whether FTCA
  coverage is being sought for each sub-recipient
  listed on their most recent Form 5B.
• For sub-recipients that decline FTCA coverage,
  the grantee is required to provide an explanation
  or upload any appropriate attachments that
  support the decision to decline coverage.

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Sub-Recipient Applications (continued)

• Health centers must submit a separate deeming
  application on behalf of each sub-recipient
  seeking FTCA coverage
• A single application package that includes the
  grantee and all appropriate sub-recipient
  applications should be submitted. Each
  sub-recipient application will be collected as
  an attachment in the system.
• The system will provide a downloadable template
  which the grantee can send to sub-recipients to
  complete and return to the grantee

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Sub-Recipient Applications (continued)

• It is recommended that the grantee download the
  template from the system and send it to all the
  sub-recipients that are requesting coverage and
  participating in the program as soon as they
  begin working on their own application
• The grantee is required to upload the
  sub-recipient application within the system once
  they have received it from the appropriate
  sub-recipients

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Paper Waiver Requests

• Limited only to applicants unable to submit
  electronically
• These applicants must submit
• Waiver Justification Letter (that should provide
  a detailed explanation regarding their inability
  to submit through EHB)
• Completed application packet
• Mailing address
• HRSA Health Center FTCA ProgramAttn FTCA Branch
  Chief Bureau of Primary Health Care, HRSA5600
  Fishers Lane, Mailstop 15C-26Rockville, MD 20857
  Fax [phone]
• Waiver justifications are subject to review and
  approval by HRSA

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Resources

• Resource Page, Quality Improvement
  https//members2.ecri.org/Components/HRSA/Pages/QI
  .aspx
• Risk Management Plan https//members2.ecri.org/Co
  mponents/HRSA/Pages/RMPlan.aspx
• Event Reporting Toolkit https//members2.ecri.org
  /Components/HRSA/Pages/EventReportToolkit.aspx
• Webinars https//members2.ecri.org/Components/HRSA
  /Pages/Webinar_Audioconf_Archive.aspx
• Clinical Risk Management Basics Part I
• Developing a Risk Management Plan

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Resources

• Sample Risk Management Policy Physician Office
  Practice https//members2.ecri.org/Components/HRSA
  /Pages/PSRMPol3.aspx
• Patient Satisfaction Questionnaire
  https//members2.ecri.org/Components/HRSA/Pages/PS
  RMPol2.aspx
• Anecdotal Note for Patient Concerns
  https//members2.ecri.org/Components/HRSA/Pages/OA
  Pol4.aspx
• Handling Patient Complaints https//members2.ecri.
  org/Components/HRSA/Pages/OAPol3.aspx
• Safety Attitudes Questionnaire (Ambulatory
  Version) https//members2.ecri.org/Components/HRSA
  /Pages/PSRMPol1.aspx

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ECRI Institute Login

• For more information or to login
• Go to http//www.ecri.org/clinical_rm_program
• Enter your user ID and password on the left-hand
  side
• To access online CME courses
• Go to http//ecrilearning.ecri.org
• Register using your health centers course keys
• Need a user ID or course keys?
• E-mail clinical_rm_program_at_ecri.org or call
  610-825-6000, ext. 5200
• Include your full name and facility name

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Resources

• FTCA Website http//www.bphc.hrsa.gov/ftca
• Call Replay available until December 31, 2011
  800-337-5610
• No passcode required
• FTCA/BPHC Help Line 1-877-974-BPHC
  (877-974-2742) or BPHChelpline_at_hrsa.gov
• 900AM to 530 PM (ET)
• For information on the FTCA Program and the
  deeming application
• HRSA Call Center 1-877-464-4772 or
  CallCenter_at_hrsa.gov
• Monday-Friday (except federal holidays) 900AM to
  530PM (ET)
• For EHB technical support (e.g., registration,
  username and password)