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Improved Patient Care: Medical liability regulatory update

In the US, Medical liability is always criticized due to costly, inefficient, and inconsistent in nature. For many decades, various reform efforts have failed to pass legislation that contains costs, stabilizes liability insurance premiums, and meaningfully promotes patient care and safety.

Culture of patient care and safety among healthcare organizations

Patient care and safety can be improved if the health care organizations are willing to take efforts to promote a culture of safety and regularly evaluate the progress towards patient care.

This culture of patient care and safety shows various aspects such as the values, assumptions, and norms related to communication, error management, transparency, a learning orientation, and teamwork which are shared among clinicians and staff.

However, limited empirical work examines linkages between the organizational culture of patient care and safety and the approaches clinicians and provider organizations take to medical liability.

During the pandemic, Patient care and safety is a top-most priority for all healthcare organization. Moreover, these organizations are witnessing various provisions regarding healthcare services.

Altering the provision of health care services due to COVID-19 pandemic

Today, The COVID-19 pandemic created a public health emergency that is the main driving force behind altering the provision of health care services across the country. These provisions are mainly based on guidance and recommendations from the Centers for Disease Control and Prevention and other federal, state, and local government directives. For instance, on March 24 the Secretary of Health and Human Services issued a letter and associated guidance urging all state governors to take a number of immediate actions which includes backing up health care professionals from medical liability.

We tried to focus on the list of liability protections act for health care professional which are currently in effect at the federal and states level.

Medical Liability protections for healthcare professionals at Federal

CARES Act

On March 27, after the consent of President Donald Trump, a new law came into existence named as “Coronavirus Aid, Relief and Economic Security Act” (CARES Act). This new law provides additional federal liability protections for volunteer health care professionals during the COVID-19 emergency response.

This law clarifies that physicians and other health care professionals who provide volunteer medical services during COVID-19 shall not be liable for providing services that relate to the diagnosis, prevention, or treatment of COVID-19 or the assessment or care of a patient-related to an actual or suspected case of COVID-19.

PREP Act

The Public Readiness and Emergency Preparedness Act (PREP) provide immunity to health care professionals (who administer or use countermeasures covered by declarations issued by the Secretary of HHS) at a broad level.

Volunteer Protection Act of 1997 

The Volunteer Protection Act of 1997 (VPA) offers liability protections to volunteers which includes physicians too, who are performing services for any government entities or nonprofit organizations. To be eligible for protection under this act public health emergency or national emergency declaration is not required.

Under this law, Physician volunteers providing medical care within their scope of practice are not liable for economic damages

Medical Liability protections for healthcare professionals at State

States have a variety of liability protections for a physician providing care in an emergency, particularly those serving as a volunteer for instance, for instance, 50-states have Good Samaritan statutes which provide immunity to licensed physicians acting in good faith who provide gratuitous care at the scene of an accident. Moreover, State laws also provide liability protections for volunteer physicians providing care in a free clinic, non-profit hospital, and non-profit organization or as part of a government organization.

The Emergency Management Assistance Compact (EMAC)

All 50-states have enacted The Emergency Management Assistance Compact (EMAC) which provides immunity to officers or employees from the rendering state to the state requesting aid, in which officers or employees are considered agents of the requesting state for tort liability and immunity purposes.

To get eligible for EMAC, a state must make a request to another state(s) through the Compact, and such request must be formally accepted by the rendering state.

The Uniform Emergency Volunteer Health Practitioners Act (UEVHPA)

The Uniform Emergency Volunteer Health Practitioners Act (UEVHPA) which grants immunity of civil liability to out-of-state licensed health professionals for gratuitous care provided in a declared emergency. However, there are some limitations regarding whom the UEVHPA applies, including only out-of-state physicians who have registered in advance or during an emergency.

States are considering ways to extend liability protections for physicians and other health care professionals in this medical emergency situation like COVID-19. Moreover, health Insurance Market is also witnessing reforms from the past few years.

Due to regulatory updates at the federal and state levels, the health insurance industry is also undergoing some reforms which are explained below.

Reforms in Health Insurance Markets

Over the past several decades, there have been many efforts to change incentive structures in health care, all with the goal of reducing health-care costs while improving patient health outcomes.

The US health insurance market is witnessing reforms in itself due to various provisions in The Affordable Care Act such as Annual limit, Coverage for Young Adults, Grandfathered Plans, etc.

These reforms are beneficial for American consumers and empowered them to take charge of their health coverage and care, ensuring they receive value for their premium dollars.

The law helps to take down unreasonable health insurance premiums and holding insurance companies accountable for unjustified premium increases.

CMS is held responsible to ensure all consumers receive protections of the Affordable Care Act, for enforcing market reforms in states that are not enforcing them directly or have not collaborative arrangement with CMS on enforcement.

Though Medical liability regulations are changing however, we have an expert coding and billing team which handles all tasks related to claims processing. Schedule a call today with our billing manager for all your billing needs.

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