Federal Tort Claims Act (FTCA)

What is it?

The Federal Tort Claims Act (FTCA) 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. Under Section 224 of the Public Health Service Act, as amended by the Federally Supported Health Centers Assistance Act (FSHCAA) of 1992 and 1995, employees of eligible health centers may be deemed to be federal employees qualified for protection under the FTCA since its enactment in 1946.

How does it work?

According to the Bureau of Public Health (BPHC) Health Center Program and Federal Tort Claims Act, 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, Bureau of Primary Health Care. There is no cost to participating health centers or their providers, and they are not liable for any settlements or judgments that are made. The Federal government assumes responsibility for these costs. The health center, their employees and eligible contractors are considered federal employees immune from suit for medical malpractice claims while acting within the scope of their employment.

Deemed Health Center Program grantees are immune from medical malpractice lawsuits resulting from the performance of medical, surgical, dental, or related functions with the approved scope of project.

A patient who alleges acts of medical malpractice by a deemed health center cannot sue the center or the provider directly, but must file the claim against the United States. These claims are then 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. HRSA pays for all settlements and judgments from a separately appropriated Health Center FTCA Judgment Fund.

Deeming Process

Health Centers eligible for FTCA protection are those funded by HRSA, under Section 330 of the Public Health Service Act. These grantees submit periodic applications to BPHC as a condition of their funding. These periodic applications are called project period renewal grant applications.

Deeming is an application process that an eligible Health Center must undertake in order to activate and maintain its FTCA malpractice protection. The law allows only organizations funded through section 330 of the Public Health Service Act, to be deemed. The deeming process, while not onerous, does have some basic requirements. Health Centers that wish to participate must assure BPHC that they conduct complete and thorough credentialing of their providers including a query of the National Practitioner Data Bank. Participating Health Centers must maintain clinical protocols, tracking systems, medical record reviews, and active quality assurance programs. Once deemed, participation is maintained through project period renewal grant applications and indicated on the Health Center's Notice of Grant Award.

A Health Center's Scope of Project is the domain described in certain segments of its grant application and approved by BPHC. Those segments include a description of the Health Center's populations served, the list of services provided, list of service delivery sites, Health Center affiliations and work plan. A Health Center can change its scope of project throughout its project period by adjusting those fundamental documents and seeking approval for such change from BPHC.

An individual's Scope of Employment is defined by the duties and responsibilities of an employee or contractor as identified by a written job description or contract, along with other related performance responsibility documents.

Credentialing is the process for verifying that a provider is appropriately licensed or certified, and for evaluating the quality of that provider's work history. Most health plans and hospitals credential providers that practice with or for their organization. The Federally Supported Health Centers Assistance Act of 1992 requires, and PIN 2001-16 reiterates, that each deemed Health Center that participates in the FTCA must credential all its physicians and all other licensed or certified health care practitioners, set up a periodic privileging policies and procedures for those practitioners, and follow those policies and procedures.

Resources

To better understand the FTCA regulations and its applicability to health centers, here’s the list of Program Information Notices (PINs) and Program Assistance Letters (PALs) that were released by HRSA specifically for the Health Center FTCA Program as well as publications from the National Association of Community Health Centers (NACHC):

BPHC PINs and PALs

FTCA Application Process

Program Assistance Letter 2014-09

Federal Tort Claims Act (FTCA) Health Center Policy Manual

Federal Tort Claims Act (FTCA) Coverage for Health Centers Responding to Emergencies

Clarification on Credentialing & Privileging Policy

NACHC Publications

Click here to view the list of FTCA-related publications on the NACHC website.