The Federal Torts Claim Act (FTCA) is admittedly not the most exciting read. In fact, getting through the legalese can be a real chore. Nevertheless, it’s critical for health center administrators to understand FTCA—and what to do in order to demonstrate compliance.
Here’s why: In order to maintain your health center’s status as a federal Public Health Service (PHS) employee (which confers numerous benefits to your health center and employees), you must demonstrate FTCA compliance to HRSA every year.
This requirement is mandated by sections 224(g)-(n) of the PHS act. We highly recommend that someone from your health center review section 224 in full. (Sorry! We know it’s not exactly riveting either.)
So, how do you demonstrate compliance? We’re going to explain.
The basics of compliance requirements
If and when tort claims are filed against your FQHC, the federal government will inevitably get involved. This means that HRSA wants to know that your health center has sound policies and procedures in place to prevent lawsuits, and to deal with them effectively if a lawsuit is filed against you.
There are several requirements:
- You have implemented policies and procedures to reduce the risk of malpractice lawsuits and other lawsuits related to the healthcare services provided by your health center.
- Your health center has thoroughly reviewed the credentials, licensing status, and claims histories of all physicians and other clinicians employed by your health center.
- You have no history of claims against your health center. If claims have been made against your history, then you must demonstrate that you have fully cooperated with the Attorney General in defending such claims. You must also show that you’ve taken steps to prevent similar claims from being filed in the future.
- Your health center will cooperate with the Attorney General and other federal agencies in providing necessary information, as defined by section 224.
So, how do you do all of this?
How to demonstrate compliance
These requirements seem daunting. But in fact there are several concrete steps your health center can take to demonstrate your compliance. Here’s what to do:
- Appoint someone on your staff to the position of Risk Manager. The Risk Manager will be responsible for performing quarterly risk assessments and otherwise taking proactive measures to reduce risk. When the Risk Manager sees potential risks, you must take steps to mitigate them before they become bigger risks. They need to be tracking patterns and implementing risk mitigation solutions.
- Show that your health center is fully compliant with all HRSA requirements related to the credentialing and privileging of clinical staff. We’ve written another blog article about this previously if you don’t know where to start.
- Demonstrate that your health center has and implements a risk management program with the goal of reducing the risk of medical malpractice lawsuits. Your risk management program should include things like risk management training for clinical staff, documentation of clinical complaints from patients, and tracking progression towards annual risk management goals.
The Risk Manager should compile documentation showing the steps you’ve taken to implement a robust risk management program. For additional suggestions on how to implement a risk management program, see chapter 21 of the HRSA compliance manual.
- Provide mandatory risk management training to all clinical staff. Be prepared to show evidence that all staff members actually completed the training. It’s also helpful to show materials that outline the curriculum of your program.
- The Risk Manager must provide regular reports to the Board and key staff members about risk management. Discussion of this issue should be documented in your Board minutes and other reports. Again, prepare copies of these reports to show HRSA. If it wasn’t fully documented, then it didn’t happen as far as HRSA is concerned.
In the event that the Board requested additional information about risk management, you need to demonstrate that this information was actually provided in a timely fashion. And yes, this does mean more paperwork.
- Show documentation that outlines your policies and procedures for processing claims. Any claims against your health center should be fully documented, including your response and evidence of your cooperation with the Department of Justice and other federal agencies.
So, yes, we are advocating that you produce a pretty massive paper trail. This may mean a lot of dead trees—but it is vital for your health center to remain compliant under FTCA and PHS.
For more tips on how to document your compliance to HRSA, follow RegLantern on social media. We’re covering every aspect of the compliance process to make it easier for you.