Health Center Frequently Asked Questions
What is the Federal Tort Claims Act?
The Federal Tort Claims Act (FTCA), established in 1946, is the legal mechanism for compensating people who have suffered personal injury due to the negligent or wrongful action of employees of the U.S. government.
Does the Federal Tort Claims Act apply to health center employees?
Yes, in certain circumstances. Under section 224 of the Public Health Service (PHS) Act, as amended by the Federally Supported Health Centers Assistance Act of 1992 and 1995, employees of eligible health centers may be deemed to be Federal Employees qualified for protection under the FTCA.
What are the benefits of FTCA coverage?
- By providing medical malpractice protection to health centers that meet annual program requirements, the Health Center FTCA Program saves Health Center Program grantees millions of dollars yearly that they can then invest to increase health care services and fund quality improvement activities.
- As Federal employees, the employees of qualified health centers are immune from lawsuits. The Federal government acts as their primary insurer.
Do FTCA deemed health centers and FTCA covered individuals need to purchase "tail insurance" for their FTCA covered service at the health center after they leave the FTCA deemed health center?
As an additional benefit of FTCA coverage, a covered individual of an FTCA deemed health center who leaves that health center is protected for all covered activities resulting in allegations of medical malpractice that occurred while he/she was working as an officer, governing board member, employee, or qualified individual contractor of the deemed health center. This protection is contingent upon the covered individual meeting all of the requirements of FSHCAA. Since FTCA coverage is analogous to an occurrence form of malpractice insurance, covered entities (deemed health centers) do not need to purchase tail coverage for individuals whose activities were protected by the FSHCAA for actions occurring after they are no longer employed by or contracted with the covered entity.
What services are covered under the FTCA Program?
Deemed Health Center Program grantees are immune from medical malpractice lawsuits resulting from the performance of medical, surgical, dental, or related functions within the approved scope of project.
How can verification of FTCA coverage for individual providers be established?
To streamline this process, HRSA no longer uniformly provides separate written confirmation of medical malpractice coverage for covered individuals. Health centers are provided their Notice of Deeming Action (NDA), together with documentation confirming a covered individual's employment or contractor status with the deemed entity, to show liability coverage for damage for personal injury, including death, resulting from the performance of medical, surgical, dental, or related functions by Public Health Service (PHS) employees while acting within the scope of such employment.
How do I know if I’m eligible to be covered under the FTCA?
You must work for a health center that is eligible to participate in the FTCA program. Health centers that are eligible to participate in the FTCA program include all grantees funded under section 330 of the PHS Act, including Community Health Centers, Migrant Health Centers, Health Care for the Homeless Centers, and Public Housing Primary Care Centers.
- Eligible health centers must apply for FTCA coverage.
- All employees and qualified contractors of health centers that are deemed covered by the U.S. Department of Health and Human Services are covered under the FTCA program. Volunteers are not covered by the FTCA program.
How does a health center apply for the FTCA program?
Eligible health centers must submit an original deeming and annual renewal deeming applications to the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Bureau of Primary Health Care (BPHC). Information on how to apply can be found in Health Center Application Process.
I receive section 330 funding through my H80 grant as well as ARRA grants (NAP - H8A, IDS - H8B, etc.). Do I need to submit a separate FTCA application for each grant belonging to section 330?
No. You only need to submit one, consolidated FTCA application from your H80 grant handbook. This application should reflect your entire section 330 organization, including any ARRA funded site(s) and/or provider(s).
Where do I find the link to begin the FTCA application?
The “FTCA Program” link will be available in your H80 grant handbook. Log into EHB. After successfully logging in, choose the “view portfolio” on the left side. Then choose the “open grant handbook” under the H80 grant handbook. You will see the “FTCA Program” link on the lower right side of the page.
Who will be able to view the FTCA Program link?
Everyone who has the H80 grant in their EHB portfolio will be able to view the FTCA Program link.
Will everyone with access to the H80 grant be able to begin working on the application?
No. Initially, only the H80 Project Director (PD) has the appropriate level of permission to work on the FTCA application. The PD may choose to add additional permissions to allow others to work on the FTCA application.
I am a PD and I want to delegate someone else to work on the FTCA application. How do I do that?
Open the “Grant Handbook” under your portfolio.
Choose the “New/Existing Users” under the “Administer” on the left hand side.
Search for the user who you wish to grant the additional privileges.
Once you have identified the user, choose to “update privileges” for the user.
You will have the option to provide various levels of FTCA access for this user and save it.
What can I do if the system incorrectly states that my organization is submitting an initial deeming application (or vice versa)?
You have the ability to change the system default value (e.g., from initial to redeeming) and provide justification from the “Select Application Type” page when you begin working on your FTCA application.
How do I credential providers? What about locum tenens, residents, etc.?
All licensed or certified health care providers who work or volunteer in the health center must undergo a credentialing and privileging process in accordance with Policy Information Notice 2002-22 (PDF - 81 KB): Clarification of Bureau of Primary Health Care Credentialing and Privileging Policy Outlined in Policy Information Notice 2001-16.
What is a sub-recipient?
According to the Federal Tort Claims Act Health Center Policy Manual (PDF - 369 KB), a sub-recipient is defined as “an entity (not an individual contractor) that receives a grant or a contract from a deemed health center to provide the full range of health services on behalf of the deemed health center and only for those services under the scope of the project. Sub-recipients can be eligible for FTCA coverage. Contractual relationships with other entities for individual services (e.g., laboratory, pharmacy, physician services) are not subject to FTCA coverage.” A sub-recipient must also be identified as a part of the health center’s approved scope of project.
How do sub-recipients apply?
To ensure the completeness of application processing and review, health centers will be required to submit a separate deeming application on behalf of any sub-recipient identified on their most recent Form 5B that is seeking FTCA coverage. Sub-recipient organizations will be required to submit their applications and supporting documentation in accordance with the deeming guidance specified within the annual deeming Program Assistance Letter (PAL). Please see the Health Center Application Process.
To submit the QI/QA Plan should health centers attach the entire document?
Yes. Please attach the entire QI/QA Plan document.
How often should the QI/QA Plan be reviewed and approved?
The health center’s governing Board must approve the QI/QA Plan at least every 3 years and the QI/QA plan should include the Board-approved date along with a signature from the Board President or Secretary.
I am a newly funded health center applying for initial FTCA deeming, should I have private malpractice insurance in place until I become deemed?
Yes. Health centers should continue with existing medical malpractice coverage or purchase such coverage until the deeming application has been reviewed and approved and a deeming letter is issued to the organization. Also, FTCA only provides "tail coverage" for qualified occurrences that happen during the period that a grantee is deemed.
Does my organization need to be accredited?
The FTCA application process requires applicants to disclose whether or not they are accredited; and if so, by whom. There is no requirement for health clinics to be accredited in order to participate in the FTCA program. Although accreditation is expensive, the FTCA will cover the expense if health centers wish to pursue it. The free clinic application does not currently address accreditation.
For additional information, learn how to apply for accreditation.
What happens when a patient wants to file suit against an FTCA-covered health center or health center employee?
- A patient who alleges acts of medical malpractice by a deemed health center cannot sue the health center or the provider directly, but must instead file the claim against the United States government.
- These claims are reviewed and/or litigated by the U.S. Department of Health and Human Services Office of the General Counsel and the Department of Justice according to FTCA requirements.
How can I receive a claims history?
HRSA does not provide a claims history for providers. We encourage you to carefully review both FTCA and relevant Health Center Program guidance found on Health Center Program Policies, including the Federal Tort Claims Act Health Center Policy Manual (PDF - 369 KB), Section II. Please check the National Practitioner Data Bank (NPDB) for information regarding a type of claims history provided by NPDB.
This site and any information contained herein is intended for informational purposes only and should not be construed as legal advice or a determination of coverage for a specific factual situation. Deemed health centers should be aware that the Federal courts and the Department of Justice may have primary roles in determining coverage for FTCA cases in litigation.