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This Program Assistance Letter (PAL) provides policy clarification regarding the Health Resources and Services Administration/Bureau of Primary Health Care’s (HRSA/BPHC) restriction on Federal Tort Claims Act (FTCA) coverage of corporations under contract with health centers to provide medical care and treatment.
The 1995 amendments to the Federally Supported Health Centers Assistance Act (FSHCAA) clarified that section 224 provides for FTCA medical malpractice coverage for health centers’: (1) officers; (2) governing board members; (3) full and part-time employees; (4) licensed or certified health care practitioner contractors (who are not corporations) working full-time (i.e., on average at least 32 ½ hours per week); and (5) licensed or certified health care practitioner contractors (who are not corporations) providing part-time services in the fields of family practice, general internal medicine, general pediatrics, or obstetrics and gynecology. Section IV of the HRSA/BPHC Program Information Notice (PIN) 99-08 (Health Centers and the Federal Tort Claims Act) noted that:
For contract providers, the contract must be between the Health Center and the individual provider. All payments for service must be from the Health Center to the individual contract provider. A contract between a deemed Health Center and a provider’s corporation does not confer FTCA coverage on the provider.
PIN 99-08 includes all the general program requirements for participation in the Health Center FTCA Program. PIN 99-08 has not been superseded by subsequent, more general PINs.
It remains the Department of Health and Human Services’ position that services provided pursuant to a contract between a deemed health center and any corporation, including eponymous professional corporations consisting of only one health care provider, will not be covered under this program. Thus, for contract practitioners to be covered under the FSHCAA, they must contract with the health center as individuals and not through their professional corporations. In addition, all payments for service must be made from the health center directly to the individual contract practitioner and not to that practitioner’s professional corporation. Services provided pursuant to a contract between a FTCA deemed health center and any corporation, including eponymous professional corporations consisting of only one health care provider, will not be covered under the Health Center FTCA Program.
If you have any questions regarding the restriction on FTCA coverage of corporations under contract with health centers, please contact Ms. Aida Ortiz Stark, J.D., L.L.M., HRSA/BPHC FTCA Program Manager at Astark@hrsa.gov or on (301) 594-4442.
FTCA coverage for eligible BPHC grantees was initially legislated through the Federally Supported Health Centers Assistance Act (FSHCAA) of 1992 (Public Law 102-501) by amending section 224 of the Public Health Service (PHS) Act. The FSHCAA of 1995 (Public Law 104-73) clarified the 1992 Act and eliminated its sunset provision, making the program permanent.
The intent of the law is to increase the availability of funds for the provision of primary health care services by reducing health centers’ malpractice insurance premium expenditures. The FSHCAA accomplishes this by making FTCA deemed health centers (and their officers, directors, employees and certain contractors) employees of the Public Health Service for purposes of medical malpractice insurance protection. As Federal employees, these health centers and individuals are immune from medical malpractice suits for actions within the scope of their employment. The FTCA applies to acts or omissions of covered entities in the performance of activities within the BPHC approved scope of project. Volunteers are neither health center employees nor contractors and therefore are not eligible for FTCA coverage.
An organization must be “deemed” by the Secretary of Health and Human Services in order for it to be covered under the FTCA. An organization must receive a grant under section 330 of the Public Health Service Act and must complete a deeming application that demonstrates that it meets the FTCA Program requirements. Once the application is approved by HRSA/BPHC, a deeming letter is issued confirming the health center’s deemed status and the date the FTCA coverage starts.
If you have general questions on health center FTCA coverage, please contact the FTCA helpline at 866-FTCA-HELP (866-382-2435). For more specific questions about the Health Center FTCA Program, please contact Ms. Susan Lewis, R.N., C.O.H.N.-S, HRSA/BPHC Health Center FTCA Program Risk Management Coordinator, at Slewis@hrsa.gov or on (215) 861-4364.
Issued October 6, 2004 - Last reviewed November 22, 2006 |
