Health Center Regulatory Issues

HRSA Issues Revised and Updated FTCA Manual

On July 21, 2014, HRSA issued a new Federal Tort Claims Act: Health Center Policy Manual – which updates and supersedes the prior manual (PIN 2011-01), as well as a Program Assistance Letter (PAL) explaining the updates and modifications (PAL 2014-09). The new updated manual reflects an expansion in Federal Tort Claims Act (FTCA) coverage for certain services provided to non-health center patients, which was published as a final rule in the Federal Register on September 23, 2013.

Specifically, Sub-section I.C.4 of the manual expands FTCA coverage to include services provided to non-health center patients experiencing certain individual emergencies, provided that the health center provider is furnishing (or is about to furnish) FTCA covered services within the center’s scope of project and is asked to temporarily assist in an individual emergency situation at or near the provider’s location. This could include, for example, situations under which a health center provider is rounding a hospitalized health center patient and asked to assist with an emergency occurring with another inpatient who is not a health center patient. To be eligible for coverage, HRSA requires the health center to have documentation verifying that the provision of such individual emergency treatment is a condition of the provider’s employment at the health center. According to the manual, documentation could include “employee manual provisions, health center bylaws, or an employee contract.”

Sub-section I.C.4 also clarifies that: (1) FTCA coverage is available when, on behalf of the health center, a health center provider conducts or participates in health fairs and immunization campaigns (previously, coverage was available when the health center conducted those activities directly but it was unclear whether FTCA extended to participation in a health fair or immunization campaign conducted by another organization); and (2) the covered immunization campaigns include immunizations provided to both children / adolescents and adults. Both of these clarifications were published in the September 2013 final rule and update prior policy published in the Federal Register in 1995.

Finally, the new manual updates certain links and contact information. Specific updates include the following:

Sub-section I.G. The Deeming Application Process: provides an updated link to information on deeming applications.
Sub-section II.J. Overview of Claims Filings & Section III Appendix: provides updated contact information for the General Law Division within the Office of the General Counsel of the Department of Health and Human Services.
Endnotes 6 and 9: provide updated links to the Bureau of Primary Health Care Policy Website