deeming requirements and application process for ftca medical malpractice coverage health resources...
TRANSCRIPT
DEEMING REQUIREMENTS AND APPLICATION PROCESS
FOR FTCA MEDICAL MALPRACTICE COVERAGE
Health Resources and Services AdministrationBureau of Primary Health CareOffice of Quality and Data
Today’s Call1. 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
206/01/11
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/policiesregulations/policies/pal201105.pdf
306/01/11
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
406/01/11
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
506/01/11
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
606/01/11
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
76/01/2011
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
806/01/11
New Application Requirements(continued)
Clinical policies and procedures for the following activities:
Referral Tracking Hospitalization Tracking X-Ray Tracking Lab Result Tracking
906/01/11
Additional Application Requirements
A complete initial or redeeming application must include:
1. An Application Form completed in EHB
2. An approved Quality Improvement/Quality Assurance Plan, including governing board signature and approval date
3. 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
1006/01/11
Additional Application Requirements (continued)
A complete initial or redeeming application must include:4. Explanation of any “NO” responses
5. Deeming applications for any sub-recipients (as documented on the organization’s most recent approved scope from FORM 5B - see “sub-recipient submission instructions.”)
1106/01/11
Additional Application Requirements (continued)6. 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
1206/01/11
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
1306/01/11
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
1406/01/11
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
1506/01/11
Start here
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
1606/01/11
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FTCA Module in EHB (continued)
Begin Application Data Entry: The system will label the
organization’s FTCA application as “Initial” or “Redeeming” based on the grantee’s 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
1706/01/11
FTCA Module in EHB (continued)
1806/01/11
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
FTCA Module in EHB (continued)
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Application Data Entry (continued): The system does not validate the content of the attachments that
are uploaded–grantees 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.
06/01/11
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
2006/01/11
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, FAQ’s on the BPHC home page, and the FTCA system user guide
2106/01/11
Sub-Recipient ApplicationsGrantees 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.
2206/01/11
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.
2306/01/11
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
2406/01/11
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
2506/01/11
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: 301-594-5224
Waiver justifications are subject to review and approval by HRSA
2606/01/11
Resources Resource Page, Quality Improvement:
https://members2.ecri.org/Components/HRSA/Pages/QI.aspx Risk Management Plan:
https://members2.ecri.org/Components/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
2706/01/11
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/PSRMPol2.aspx
Anecdotal Note for Patient Concerns https://members2.ecri.org/Components/HRSA/Pages/OAPol4.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
2806/01/11
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 center’s course keys
Need a user ID or course keys? E-mail [email protected]
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 [email protected] 9:00AM to 5:30 PM (ET) For information on the FTCA Program and the deeming
application
HRSA Call Center: 1-877-464-4772 or [email protected] Monday-Friday (except federal holidays) 9:00AM to 5:30PM (ET) For EHB technical support (e.g., registration, username and
password)
3006/01/11