Professional Risk Logo
2909 Polo Parkway, Ste 100
Midlothian, VA 23113
800-318-9930
profRISK.com
100% Employee-Owned

Like us on Facebook  Follow us on Twitter  View our profile on LinkedIn  Visit our blog
 
 

October - December 2015

D&O, E&O, and EPLI Policies: What's the Difference?
 
D&O, E&O, EPLI
When practices consolidate or expand to form  Super Groups  and  Accountable Care Organizations , other professional liability exposures come to the forefront, such as D&O, E&O, and EPLI. Without coverage for these specific needs, your practice could find itself scrambling if met with a claim. Click to continue reading article.

Cyber & Reg Liability
Also In This Issue:
Do you have certificates of insurance sent to CAQH?

 

The CAQH Universal Provider DataSource credentialing initiative is no longer supporting documents sent to their previous email address
 (SupportingDocsUPD@acsgs.com)

Practitioners and participating organizations will have to submit their certificates directly to the CAQH ProView website.

Professional Risk and other insurance agencies do not have access to this website to submit the certificate on your behalf.
 

Go to: https://proview.caqh.org/pr  to submit your documents. If you have any questions, please contact your agent at Professional Risk at 804-794-0574 or 800-318-9930.

News & Events
Agency News: 
Joan Kassel
Our associate, Joan Kassel, MLIS, recently earned the Certified Professional Insurance Agent  (CPIA) designation from Professional Insurance Agents (PIA of Va and DC). Congratulations!

Recent & Upcoming Events:
The Virginia Medical Group Management Association (VMGMA)  held their bi-annual conference in September in beautiful, Norfolk, Virginia. 
Read more about the VMGMA here.

The Mid-Atlantic Podiatry Association will hold a conference in Maryland October 21-24th.

The Medical Society of the District of Columbia (MSDC) will hold their annual meeting on October 28th. Click to learn more about MSDC.

The Medical Society of Northern Virginia (MSNVA) will hold its annual dinner on December 4th. Click here to read more about MSNVA.

For more information about any events listed, please contact us!
Office Schedule
calendar
Office Closed For Holidays:
Monday, October 12
Thurs. & Friday, Nov. 26 and 27
Friday, December 25

After hours, please take a moment to visit our website for any general questions, such as reporting a claim, paying a bill, or requesting a claims history at  www.profRISK.com

Please be advised:  No coverage can be issued or bound without first speaking with an agent during normal operating hours.

Normal Operating Hours:
Monday - Friday: 9am - 5pm 
Making a Difference
Remote Area Medical Update
Remote Area Medical
By Maureen Hains, Professional Risk

In the four days I spent in Wise County, Virginia, I met so many wonderful healthcare professionals, non-medical volunteers, and people from the local community who came out just to help - a coal miner, a medical biller at a local hospital, and many friends offering moral support.

Many groups from the healthcare communities came from far and near, too many to name, but the ones who stood out the most were a large group of nurses from Flint, Michigan; VCU dental residents and physicians; UVA medical professionals of all kinds; physicians and nurses from Bon Secours hospital, both practicing and retired; and so many healthcare professionals serving with the Health Wagon, a non-profit providing mobile health services to the severely medically underserved population in Southwest Virginia.

I also met and got to know many non-medical volunteers who gave their time, driving and flying from across the country, to be present and fulfill any sort of need. I traveled with a group of 115 volunteers from the metro Richmond area, who served as general and medical support, and also organized the clothing tent, which provided over 40,000 pounds of clothing and other health, hygiene, comfort, and educational items.

Technicians, and other support, took care of things that went unseen. A man from Goochland, Virginia, donated his time and expertise setting up the pipes, tubes, compressors, and drains for the dentists. The Lions Club provided food for patients and volunteers. Many people drove around collecting trash, providing cooling rags, water, Gatorade, and snacks. But even maybe most importantly were the invisible angels who made sure the port-a-potties were clean.

While I spent 25 hours as a patient escort over the course of two days, walked over 13 miles, and gave lots of hugs, I was just a cog in the great wheel that is RAM. The healthcare professionals who gave their expertise, resources, time, and sweat are to be commended. It was truly amazing to see the massive variety of services provided from telemedicine, dental, vision, x-ray, and ultrasound, to mammograms, osteopathy, podiatry, cardiology, dermatology, plastic surgery, and more!

Opioid Addiction:
Reducing Physician Liability

opioid addiction
By: Fred Rice, 
Professional Risk Associates, Inc.

Recently, opioid addition and over-prescribing pain medication has been a big topic of interest in the news and on social media. In the last few years, we have seen several sanctions from medical boards, no matter the jurisdiction, which has led to boards actions with suspensions of licenses. Often the professional liability insurance company non-renews the physician's policy due to these board actions, which forces them into the non-standard market, increasing their cost of coverage. Non-standard policies also may not include many of the additional coverage endorsements and loyalty perks like a standard policy. Patient substance abuse might not just wreak havoc on a physician's finances, but could damage their career and reputation as well.

Risk Management & Reducing Liability 
The American Medical Association (AMA) recently published "What Physicians Can Do to Stop the Opioid Overdose Epidemic," and Patricia A. Harris MD with the AMA states, "With 44 people dying each day in the United States from an overdose of opioids, we physicians see people affected by this epidemic on a regular basis-whether it's in our local newspapers or in our own offices."  Click here to read the full article.

In addition, an article from the  Physicians Practice website shares ways physicians can reduce liability in patient addiction cases. Jeffrey D. Brunken, RPLU, CPCU, GEBS, GBDS, writes, "This past spring, the West Virginia Supreme Court ruled that patients could sue their physicians if the patients became addicted when their doctors negligently prescribed pain medication. Shockingly, most of the patients in this case were already abusing controlled substances when they sought treatment from their physicians and then claimed they became addicted as a result of the doctors' criminal abuse of prescriptions."  Click here to read the full article.

Do you think you're at risk?
If you have any questions or would like any additional information regarding patient substance abuse and negligent prescribing, please feel free to  contact me online, or by calling toll-free: 800-318-9930.
Telemedicine:
Creates Efficiencies, Requires Caution
Telemedicine
The Doctors Company , a physician-owned national medical professional liability insurance carrier, offers many risk management and patient safety resources on their website in their Knowledge Center; which is available to the public. You can read the following article and discover more risk management and patient safety resources by clicking here.

The adoption of telemedicine is growing as physicians seek innovative ways to provide clinical health care to patients who are at a distance, have a disability, or face other barriers that can impede access to quality care. Telemedicine can improve efficiencies, but security and confidentiality must be addressed.

The Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services, has identified Health Professional Shortage Areas (HPSAs)-geographic regions with an inadequate number of primary care physicians. Physicians who practice in these areas can meet the rising demand for care from a vast patient population by taking advantage of affordable technology, the convenience of Webcams and Web-based portals like Skype, secure Internet connections, and high-speed links via satellite. Physicians who are not located in HPSAs are incorporating this technology into their practices to help manage increasing patient volume.

The Centers for Medicare & Medicaid Services (CMS) reimburses physicians and hospitals that offer telemedicine to patients in HPSAs, remote sites, and rural areas. Recently, CMS also amended the Medicare Conditions of Participation for hospitals and critical access hospitals, updating the process that facilities can use for credentialing and granting privileges to practitioners who deliver care through telemedicine. In addition, many payers are reimbursing physicians who offer virtual consultations.

While the benefits of telemedicine are vast, its use and adoption must be tempered with caution. Physicians must be aware of the risks associated with access, such as patient and staff privacy, inaccuracies in self-reporting, and symptoms that may only be caught in person. Additional legal considerations for online interactions, such as licensure compliance and professional liability coverage for out-of-state interactions, must be addressed for the protection of the physician and the patient. According to the Federation of State Medical Boards, only 12 states have provided special-purpose licenses to allow for cross-border telemedicine, while most states require complete licensing if the patient is in their jurisdiction.
Additional considerations include:
  • Employing secure computer network systems with approved security codes designated under HIPAA compliance.
  • Clearly defining proper protocols for Webcams and Web-based portals.
  • Using mechanisms to protect the privacy of individuals who do not want to be seen on camera (including staff members, other patients, or patients' families).
  • Understanding how Web-based portals send encryption keys so that hackers can't access the stream and decrypt the conversation.
  • Developing a method to ensure that the person you are communicating with is not an impersonator.
  • Considering the effects that telemedicine may have on your relationship with your patients and developing strategies to ensure they feel valued.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.
InsuranceD&O, E&O, and EPLI Continued....
  
How does D&O Differ from E&O Insurance?
The difference between Directors & Officers insurance (D&O) and Errors & Omissions insurance (E&O) is linked to the level of decision-making at which the insured is operating. To simplify: Directors & Officers, or an entity acting as an executive, will need D&O coverage and Medical Directors reporting directly to a board of directors and/or officers will not need D&O coverage but rather E&O, perhaps in addition to their medical professional liability insurance.

Directors and Officers, such as a board, CFO, CEO, and COO, or an entity appointed to make operating decisions for a practice, do not need to be medical professionals or physicians. These decision-makers hold a fiduciary responsibility to the practice and their personal assets could be in jeopardy if they are faced with a lawsuit without D&O coverage in place. This is the reason why spouses are also covered on a D&O policy, because they could be named in a lawsuit as a co-owner of the director's or officer's assets.

D&O coverage would respond to claims against Directors and Officers when they are sued for their actions or inaction of their D&O duties. This coverage is different than your malpractice insurance policy, or even E&O coverage, because D&O insurance is built specifically to respond to claims against the executive level directors and officers.

An example of a potential claim could be where an officer leaves to work for a competitor (Practice 2) and engaged in unauthorized use of proprietary information and acts of unfair competition. The former practice sues Practice 2 and the D&O policy responds.   Click here to continue reading entire article.

Professional Risk Associates, Inc.
An ESOP company - 100% Employee-Owned

Making a Difference in Your Practice and Our Community