As a healthcare and business law firm, we work with many physicians employed by Federally Qualified Health Centers, or “FQHCs.” Working at an FQHC offers certain benefits and protections to providers. One such benefit is that individual providers are generally protected from civil malpractice lawsuits. Although our firm does not litigate medical malpractice actions, we work with physicians who are accused of malpractice within an action involving FQHCs to minimize damage to the physician’s reputation and record, particularly regarding reporting to the National Practitioner Data Bank (“NPDB”). This post intends to outline what a physician working at an FQHC needs to know if an individual brings a malpractice action. If you have questions regarding this blog post, the NPDB, or FQHC-related matters, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, email@example.com. You may also learn more about our law firm by visiting www.hamillittle.com.
Suit Against the United States Not Individual Doctors or Practices
The first thing to note is that if you are a physician for most FQHCs and a patient wishes to sue alleging medical malpractice, you—as the physician—and the health center are generally protected from being named in a lawsuit.
Why is that?
Under the Federal Tort Claims Act, FQHCs and their employees and eligible contractors working within the scope of the FQHC’s mission are considered federal employees. As federal employees, the health center and employees/contractors are immune from medical malpractice lawsuits. That does not mean a patient cannot sue or recover for medical malpractice; it just means the patient must sue the United States Government.
Because it is a lawsuit against the United States Government, the U.S. Department of Justice (DOJ) is involved by representing the United States in the lawsuit. The DOJ attorneys work with the Department of Health and Human Services (HHS) because FQHCs fall under the purview of HHS. The DOJ and HHS largely handle the lawsuit. Individual doctors and practices may be involved in the lawsuit as witnesses or to assist attorneys in gathering facts or understanding the circumstances raised in the lawsuit. Neither party, however, will generally be named or consulted as to the strategy of the lawsuit.
Settlement Payments and Reporting to the NPDB
Understanding the fact that the provider and practice have no say in what happens in the lawsuit, it is a stressful experience for providers. The main question providers have is: “Will this malpractice action or any settlement or payment therefrom be reflected on my NPDB report?”
The answer is: It depends.
If the United States settles the malpractice action, which is a likely outcome, the payment is not automatically reported to the NPDB. Because the provider has no say in the decision to settle, HRSA provides a quasi due process system to review the facts and settlement to determine whether the settlement should be reported. The facts of the action and settlement are sent to HRSA’s Health Center Program Support. That department may request information from the individuals involved. In determining whether the settlement should be reported, the department considers, among other factors, how much money the United States paid in settlement and whether the facts tend to show the provider committed egregious acts of malpractice.
At this stage of the process and on behalf of our provider clients, we ensure HRSA’s review team knows counsel is involved and that the provider is available to provide any information that would be helpful in their review. This helps promote a prompt review and that all correspondence is sent to counsel so that nothing is overlooked or missed by the provider. If HRSA decides the payment should be reflected on the individual provider’s NPDB report, HRSA will submit the report. If the provider believes this is an error, there may be ways to challenge and appeal the report or other ways to reduce the negative impact of the report.
If you have questions regarding this blog post, the NPDB, or FQHC-related matters, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, firstname.lastname@example.org. You may also learn more about our law firm by visiting www.hamillittle.com.
*Disclaimer: Thoughts shared here do not constitute legal advice.