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Vendor Management: A Vital Component to Risk Mitigation

Risk mitigation involves many moving parts, including your employees. However, your employees are not the only human element affecting your potential for liability. Your vendors also need special consideration. Luckily, one of CARE’s industry partners, OmniSure,(1) has compiled a list of recommendations(2) for managing the risk exposure derived from working with third-party vendors.

Tips include:

  • Confirm that a current, signed contract or agreement is on file  
  • Maintain documented proof of current liability insurance
  • Create a process to ensure vendors are compliant with regulatory requirements, licensure, and liability coverage  
  • Verify that all independent contractors have a Federal Tax Identification Number
  • Keep copies of current professional liability and worker’s compensation insurance
  • Ensure each provider’s current license is on file  
  • If applicable: maintain current CLIA waiver to do lab work  
  • Keep contracts and agreements with supporting documentation in a centralized, secure location

OmniSure also has videos and podcasts about vendor relations if you would like more information from them.

The Office of Inspector General (OIG) and the Department of Health & Human Services (HHS) have information, tips, and a searchable database(3) you can use so you can be confident in the liability you’re assuming when you hire vendors. Since the OIG has the authority to exclude individuals and entities from federally funded health care programs, you’ll want to check their LEIE (List of Excluded Individuals & Entities) database for vendors or contractors you plan to utilize at your facility.

If you don’t already have one, create a formalized process for performing due diligence on potential vendors and subcontractors. A documented process serves as the first layer of risk mitigation by ensuring that all new agreements go through the same vetting process. The next step is to train all personnel on this process so that nothing goes unnoticed or undone in the future.

Contact us today. We can review your professional liability policy to see if your current coverage provides protections for vendor liability.

Footnotes

  1. https://www.riskfitness.com/
  2. https://www.riskfitness.com/vendor-management-recommendations?cid=85fab4ed-3196-4e75-8828-a8ba9e4067ad
  3. https://oig.hhs.gov/exclusions/index.asp

2020: The Perfect Storm

As if the pandemic itself was not enough of a hurricane-like event to the healthcare industry, the upcoming tsunami of lawsuits will surely drown what’s left of health care worker morale and mental health, not to mention bank accounts. The perfect storm of fast-paced changes and dwindling resources has left some providers wondering if their practice will stay afloat throughout 2020.

The healthcare world’s ancillary industries, such as liability and litigation support, ride the same wave of uncertainty and persistent changes in priorities. Weather disaster puns aside, we all must prepare for the upcoming litigation wave now within the confines of our current conditions.

Potential litigation points specific to the healthcare industry include(1):

  • Employment issues
  • Inadequate or improper provision of PPE(2)
  • Business interruption
  • Force majeure clauses in contracts
  • Price gouging complaints
  • Personal injury caused by negligence
  • Medical malpractice
  • Fraud or misrepresentation  

The first step to preparedness is education. Become familiar with how the bullet points listed above may affect your practice. Appoint someone in your organization to serve as a point person for all things pandemic-related. That way, all potential issues can be cross referenced and addressed quickly. This person’s duty is to stay attuned to ever-changing laws and regulations, both at the state and federal levels(3). Then they can take this information and scrutinize any internal policies for necessary updates and changes.

Staying proactive is paramount to staying ahead of potential litigation. Address issues before they become incidents to prevent costly disputes. We are all riding out this storm together, not as competitors, but as one large tribe, trying to save our families, our economy, our industries, ourselves, and each other.

If you are unsure whether your current policy provides adequate coverage for issues related to COVID-19, please contact us today. We can review your professional liability policy to ensure it aligns with current mandates and guidelines.

Footnotes

  1. https://www.natlawreview.com/article/be-prepared-onslaught-coronavirus-related-lawsuits
  2. https://www.marketwatch.com/story/what-we-are-confronting-now-is-really-unprecedented-coronavirus-related-lawsuits-are-poised-to-flood-the-courts-2020-05-08
  3. https://www.washingtonpost.com/politics/2020/05/08/lawsuit-coronavirus-congress/

Telemedicine Updates During an Evolving Crisis

It’s almost impossible to keep current on the constant barrage of new and evolving information regarding telemedicine care during the COVID-19 pandemic. The AMA has updated its Quick Guide(1), which is a series of playbooks that covers best practices and resources for patient care on virtual platforms. These playbooks cover topics such as:

  • Technology (platform options and features)
  • Budgeting and contracting with a vendor
  • Implementation
  • Developing policies
  • Staff training
  • Patient education
  • Coding
  • Payments
  • Other helpful resources

The U.S. Department of Health & Human Services(2) also provides a robust website with information on these topics. They even have a separate web page with information for consumers if your patients are seeking resources and education about how telehealth works. The Center for Connected Health Policy website(3) is also a good resource. Their site breaks down current laws and reimbursement policies at the state level for telemedicine care.

Telemedicine isn’t solely dedicated to COVID-19 patients. It is a smart solution for patients with chronic conditions because it helps minimize potential spread of the virus to the medically fragile population. Telemedicine is also a great option for patients with sudden emergencies. Reducing the number of walk-in patients at provider offices, urgent care clinics, and hospital emergency rooms exposes as few patients as possible to potential infection. Telemedicine can mitigate risk while still delivering care(4).

Telehealth does present its own challenges and risks. The potential for liability increases when providers cannot assess a patient in person. Even with the advent of remote patient-monitoring tools such as blood pressure monitors, Bluetooth-enabled devices, and other wearable technology, there is no substitute for in-person care. There is even equipment that can remotely capture images and communicate biometric data, but even one missed symptom can be problematic. Therefore, it is important to have proper protocols in place when implementing a telehealth option at your practice.

We can review your professional liability policy to ensure your coverage aligns with current telemedicine mandates and guidelines.

Contact us today. We are happy to put our expertise to work for you.

Footnotes

  1. https://www.ama-assn.org/practice-management/digital/ama-quick-guide-telemedicine-practice
  2. https://telehealth.hhs.gov/providers/
  3. https://www.cchpca.org/telehealth-policy/current-state-laws-and-reimbursement-policies
  4. http://exclusive.multibriefs.com/content/telemedicine-webside-manner-and-barriers-to-care/healthcare-administration

Be Prepared for the Pandemic Aftermath

One of CARE’s industry partners, SE Healthcare, offers a COVID-19 Malpractice Mitigation Toolkit(1) for hospitals, physicians, and senior care facilities. This toolkit is designed to protect you and your team against the risk of emerging malpractice threats and potential claims related to the COVID-19 pandemic.

Even the best-intended immunity laws will not prevent all pandemic-related medical malpractice claims because those laws are often focused on protecting treatment decisions surrounding COVID-19 patients. However, many non-COVID healthcare services and procedures were modified, delayed, or cancelled due to the pandemic. In turn, this crisis has created new legal risks, and the repercussions may place your organization at risk for malpractice suits.

The COVID-19 Malpractice Mitigation Toolkit features four components:

  • Brief survey to gauge liability risk
  • Dashboard for easy review of survey results
  • Education and actionable insights related to potential risks
  • Practical tools, templates, and other resources for immediate use

Although resources are stretched thin, NOW is the time to dedicate personnel, resources, and money to establish a contingency plan for when the pandemic fallout emerges. Ask your healthcare staff to provide input on what to include in the plan. Think about areas of risk specific to your health care practice. Potential areas susceptible to future litigation include:

  • Delayed diagnosis of other diseases
  • Ineffective care due to limited resources
  • Failure to appropriately implement telemedicine procedures leading to failed or delayed diagnosis
  • Lack of policies or procedures to prevent pandemic shortages
  • Failure to adequately create, update, or implement emergency preparedness plans
  • Inability to ensure ethical guidelines in place for appropriate allocation of resources
  • Failure to appropriately assure competencies for expanded scope of practice

Contact SE Healthcare(2) to learn more about this valuable toolkit. Here at CARE, we can show you other resources and benefits available to CARE members to help your practice navigate ever-changing mandates and policies.

Footnotes

  1. https://www.sehealthcarequalityconsulting.com/covid-19-malpractice-mitigation-toolkit/
  2. info@sehqc.com
  3. https://care-ins.com/contact/

From Triage to Trial

Healthcare professionals working the front lines are faced with difficult decisions every day. Compound that with the COVID-19 pandemic, working around the clock, and worrying about their own health and safety. Basic triage decisions have evolved into heartbreaking shifts, with hardly any respite for those facing the onslaught day after day.

As is the norm in our litigious culture, what will follow is a wave of potential malpractice suits(1), some due to the triage decisioning process, and others because healthcare facilities lack basic supplies, such as face masks and ventilators. While it seems unthinkable to accuse a medical professional of making the wrong decision when they are putting themselves at great personal risk to treat so many others, it will happen.

The key to triaging patients during a global pandemic is consistency. It is paramount to determine – and stick with – clear, concise, specific policies that do not discriminate based on subjective criteria. A healthcare professional cannot simply decide if a patient is too old or too sick (based on other comorbid conditions) every time they triage a new patient. The clearer the guidance, the more objective employees can be. Follow up these decisions with proper documentation to ensure that guidelines were followed, and the documentation can serve as the collective memory, even once this pandemic has past.

There’s also the question of how to determine what a pandemic triage policy should be, when (hopefully), each of us will only go through something so impactful once in our lifetimes. For example, the next outbreak might not require such a large demand for ventilators, so how do we determine (and who decides) what is normal or expected?

In terms of prevention, healthcare facilities can support their personnel by addressing the anxiety and confidence dips that are normal during a global health crisis. Health care workers cannot calm and reassure the public when they aren’t being reassured themselves. The concerns of health care professionals can be summed up in five categories: hear me, protect me, prepare me, support me, and care for me(2).  

There is no clear way to end an article about an ever-evolving situation. So much is unknown and uncertain. The most important thing we as professionals in the healthcare industry can do right now is protect ourselves. And each other.

Footnotes

You’re a Specialist? You Need Specialized Coverage.

While a general practitioner is usually comfortable with basic medical liability coverage, specialty providers have specific needs and circumstances that merit special consideration. If you are a specialist, consider seeking malpractice coverage from a company that knows the specifics of your industry.

CARE Professional Liability Association, LLC offers the following types of specialty coverage:

  • Dental
  • Chiropractic
  • Pain Management
  • Medical Directorship
  • Bariatric Surgery

A CARE policy offers solid, affordable coverage to physicians from coast to coast. Our goals are to offer the lowest premium possible and tailored flexibility to meet a specialty practice’s needs. Some features of a CARE policy include:

  • Claims-made coverage
  • Limits available that meet or exceed state requirements
  • Death, disability, and retirement (DD&R) available
  • Coverage for multi-specialty groups
  • Ancillary personnel can be covered on a shared limit basis (subject to certain restrictions)
  • Special pricing for part-time, low-volume visits, low reads, deliveries, and surgery
  • Multiple deductible options available
  • Policy can be tailored to meet the specialty physician’s needs
  • Proactive risk management program included with policy
  • Installment financing available

According to a 2019 Medscape survey, approximately 59% of physicians who responded said they have been named in a malpractice suit(1). Given that statistic, providers need to carefully consider their liability coverage options. A robust policy is a substantial investment, but it can also save your practice from bankruptcy should you ever be involved in a malpractice claim. Policy costs vary greatly, depending on the type of medical professionals covered in the policy(2). This is one reason why you should partner with a risk retention group that understands the nuances of specialty practices. It’s an art and a science balancing coverage and cost, and experienced underwriters can develop a policy that provides you with the best solution.

Contact us today. Our underwriters understand the challenges of specialty practices. Put our years of experience to work for you.

Footnotes

Preparing Your Practice for Telemedicine Care

The COVID-19 pandemic has healthcare providers evolving their practices daily as protocols for diagnosing and treating the virus change so quickly. Telemedicine has become an effective means of triaging patients while limiting exposure for both patients and office staff.

The AMA(1) has issued a guide to quickly establishing a telemedicine offering at your practice. Some suggestions include:

  • Establish an implementation team
  • Review malpractice insurance policy
  • Evaluate payment guidelines   
  • Select third-party vendor to provide services
  • Ensure HIPAA compliance
  • Train clinicians, care team members, and schedulers
  • Set up telehealth space at your location
  • Determine documentation protocols
  • Ensure you receive advanced consent from patients for telemedicine interactions
  • Conduct proactive patient outreach to spread awareness of telemedicine offering

The Department of Health and Human Services(2) has issued guidance to health care providers who are new to providing telemedicine options to their patients. They have confirmed that covered health care providers will not be subject to penalties for violations of the HIPAA Privacy, Security, and Breach Notification Rules that occur during the good faith provision of telehealth during the COVID-19 nationwide public health emergency. This notification does not affect the application of the HIPAA Rules to other areas of health care outside of telehealth during the emergency.

CMS (Center for Medicare & Medicaid Services)(3) has issued guidelines for Medicare and Medicaid patients. For private insurers, several healthcare companies have announced that they will make telehealth more widely available. Some are offering telehealth services for free for a certain period of time.

Contact us today. We can review your professional liability policy to ensure your coverage aligns with current telemedicine mandates and guidelines.

Please Note: Any communications relating to the impact of coronavirus/COVID-19 on insurance policies or healthcare protocols are not legal opinions, warranties, or guarantees, and should not be relied upon as such. We do not render legal advice or make coverage decisions regarding COVID-19 claims. Given the ongoing and constantly evolving pandemic situation, this communication does not necessarily reflect the latest information regarding recently enacted, pending, or proposed legislation or mandates that could override, alter, or affect existing insurance coverage. Please consult with an attorney for specific legal advice in this regard.

Footnotes

Important CDC Resources During the Pandemic

The CDC urges healthcare facilities and provider practices to assess their protocols to help prevent the spread of COVID-19. The CDC has provided the following resources to aid healthcare providers in these efforts:

Also be sure to keep the CDC Emergency Operations Center number readily available for emergency or urgent patient care assistance (not intended for use by general public): 770-488-7100. It is staffed 24 hours a day, seven days a week.

Contact us today. We can review your professional liability policy to ensure your coverage aligns with current mandates and guidelines.

Please Note: Any communications relating to the impact of coronavirus/COVID-19 on insurance policies or healthcare protocols are not legal opinions, warranties, or guarantees, and should not be relied upon as such. We do not render legal advice or make coverage decisions regarding COVID-19 claims. Given the ongoing and constantly evolving pandemic situation, this communication does not necessarily reflect the latest information regarding recently enacted, pending, or proposed legislation or mandates that could override, alter, or affect existing insurance coverage. Please consult with an attorney for specific legal advice in this regard.

Are You Prepared if the Coronavirus Knocks on Your Door?

With the coronavirus making landfall in the continental United States, is your staff prepared to handle potentially infected patients? All medical offices, no matter their size or specialty, should have an infection control and emergency preparedness plan in place. A solid plan, coupled with thorough screenings, can aid the healthcare community as a whole better manage this outbreak(1).

If you and your staff are not already familiar with the CDC’s educational site, now is the time to circulate that information, which can be found here: https://www.cdc.gov/coronavirus/2019-ncov/index.html(2). While a global epidemic can seem frightening, especially to healthcare workers, education is one of the best weapons you can provide your staff. Media reports, while helpful in disseminating information quickly, can also cause undue stress and panic among uninformed populations.

Proper resource management is essential for a healthcare practice during potential pandemics. For example, non-healthcare venues affect absenteeism at your practice. Consider how schools, childcare centers, and other business closings affect your staff. Be sure to work these contingencies into your emergency preparedness plan. Also give thought to how other local infrastructure, such as law enforcement and the transportation industry, affect your practice.

The World Health Organization (WHO) has released an online training program that may prove beneficial to you and your staff. It can be accessed via this link: https://openwho.org/courses/introduction-to-ncov(3). The course, which was published on January 26, 2020, has already seen a large volume of registered users – almost 3,000 daily. It is free to enroll, and is currently being produced in many languages across the globe. The World Health Organization believes that dispersing this type of knowledge into the hands of first responders (such as you and your staff) is paramount in controlling the outbreak of the coronavirus.

Contact us today. We can provide additional resources and training ideas to create an emergency preparedness plan that your practice can put into place immediately.

Footnotes

Are you familiar with the SUPPORT Act and EKRA?

Not one to shy away from lengthy acronyms, Congress passed the SUPPORT Act (Substance Use Prevention that Promotes Opioid Recovery and Treatment) a couple of years ago. What is it? The Act is an attempt to manage various issues related to the opioid crisis through a series of more than 70 separate bills.(1)

Some important highlights of paramount importance to providers include:

  • States must establish a qualifying prescription drug monitoring program (PDMP) and require healthcare providers to check the PDMP for an enrollee’s prescription drug history before prescribing controlled substances. There has been a great deal of discussion about the ability for physicians and pharmacies to track usage in other states as well.
  • The bill increases the maximum number of patients that healthcare providers may initially treat with a medication-assisted treatment plan
  • The Eliminating Kickbacks in Recovery Act (EKRA) is one of the SUPPORT Act’s related bills. This tightens up the laws that make it a federal crime to receive/offer illegal remunerations for patient referrals to recovery homes, clinical treatment facilities, and laboratories.(2)

As with any legislation, there are still issues regarding the applicability of the Act to unrelated arrangements in the healthcare industry that could otherwise be structured to comply with existing federal law.(3) Additionally, EKRA has been criticized as being overly broad and ambiguous.(4)

New laws usually result in new issues for healthcare providers. The more time providers spend trying to figure out what the government wants them to do, the less time they have to dedicate to patient care. What can you do to protect yourself from the potential liability surrounding these new laws? Education is of vital importance, as is ensuring that your risk mitigation plan addresses these issues.

Contact us today. We can help you make sense of these and other laws that affect your risk management plan.

Footnotes