FTCA Application Changes for CY 2024

On February 2, 2023, HRSA released their “PAL 2023-01 Calendar Year 2024 Requirements for Federal Tort Claims Act (FTCA) Coverage for Health Centers and Their Covered Individuals”. We have compared this year’s application with last year’s PAL and have noted the important information and changes below.

We have reviewed the new PAL in detail and there are a few areas all FTCA applicants will want to know about:

• IMPORTANT: The EHBs system will be available to begin receiving CY 2024 deeming applications on Friday, April 28, 2023.

• IMPORTANT: Each currently deemed entity must submit a redeeming application for itself and any subrecipients (as applicable) by Friday, June 23, 2023, to be eligible to be deemed during CY 2024 without a gap in coverage.

• IMPORTANT BUT SAME AS LAST YEAR: Applicants will again be required to submit a Credentialing List with provider information to help verify compliance with deeming requirements. All provider information on the Credentialing List must have been renewed (“re-credentialed/re-privileged”) within the last two years from the date of your FTCA application submission. As it was last year, the FTCA application in EHB will not accept document uploads of the Credentialing & Privileging Staff List. Health Centers are required to manually type in the information into the EHB application. This is not a quick process so leave plenty of time to do this! It is believed that the clinical staff information that your team entered in last year will still be there but we will not know for sure until the application opens on April 28, 2023. Regardless, it is prudent for health centers to leave plenty of time to complete this tedious part of the application!

• SIGNIFICANT CHANGE: In the “Review of Risk Management Systems” language has been added to question 3(A) stating that the health center attests that their Risk Management Training Plans incorporate OB procedure risk management training for, “health centers who do not provide OB services directly but may have contact with reproductive age patients for other clinical services”. This is a significant deviation from previous requirements as previous versions of FTCA guidance indicated that OB risk management training was not needed if no direct OB services (Form 5A, Column I) were provided by the health center.

• SIGNIFICANT CHANGE: In the “Credentialing and Privileging” section, question 4, language was changed to state that the health center must attest to maintaining clinical staff files that contain documentation of, “the verification, at least every two years, of credentialing and privileging requirements outlined in Chapter 5 of the Health Center Compliance Manual, consistent with the health center’s operating procedures.”. The credentialing and privileging has typically been completed every two years in most health centers, the current Compliance Manual (August 20, 2018) and Site Visit Protocol (May 26, 2022) states that credentialing and privileging must be done “upon hire and on a recurring basis”. In some locations it presents, “for example, every two years”. But this has typically been viewed only as an example. In reality, an overwhelming majority of health centers already default to two years being the standard frequency. However, it is important to note this change if your health center’s credentialing and privileging cycle is less often than every two years.

• MODERATE CHANGE: In the “Credentialing and Privileging” section, Roman numeral “vii.” was added stating that the health center attests that their operating procedures ensure verification of “Any other credentialing information required by applicable law to be completed for health care providers (e.g., state laws requiring background checks)”. This is listed as a moderate change as health centers have always been expected to follow state and other local laws. However, this is the first time we have seen this language explicitly listed in this section of the application.

• INSIGNIFICANT CHANGES:

  • In the “Review of Risk Management Systems” section of the FTCA application, question 2(A), the word “ongoing” was inserted to read, “I attest that my health center has implemented ongoing risk management procedures…”. Similar phrasing was added in the “QI/QA” section, questions 1(A) and 1(BA) in regard to the “ongoing” QI/QA program. Again in question 3, “and maintains” was added in regard to implementing and maintaining systems and procedures protecting patient confidentiality. In the “Credentialing and Privileging” section, questions 1(A) and 2(B), “ongoing” is again added in regard to an ongoing credentialing and privileging processes. It is unclear if these words will change any interpretation of these attestations but it is our assumption these are phrases added to signify HRSA’s wishes to move health centers toward continuous compliance.

  • Examples of required trainings were added to question 3(C) in “Review of Risk Management Systems”: “(Obstetrical, infection control and sterilization, HIPAA medical required confidentiality and security), and areas of high risk”. This addition does not seem to deviate from previous requirements.

  • Language indicating that “systems and procedures are consistent with federal and state requirements” was added to question 3 in the “QI/QA” section. Similar language was removed from the next question (number 4). These changes do not seem to deviate from previous requirements.

  • Minor wordsmithing in the “Credentialing and Privileging” section, question 2(A), point “i”. The phrases, “…which may include…” and “…to the extent applicable to health care providers by applicable law…” were added to this section. These changes do not seem to change the content of the section significantly.

  • Minor wordsmithing in the “Credentialing and Privileging” section, question 5. These changes do not seem to change the content of the section at all.

  • There were other minor grammatical changes throughout the documentation that did not change the content of the application.

The RegLantern platform has got you covered for this year’s FTCA application. If you are using RegLantern’s Credentialing & Privileging module, you are able to export this Credentialing List as required by the FTCA Application. If you have any questions or need help preparing for your HRSA/FTCA application submission, please contact us on our website here.

Also, RegLantern has created a new FTCA Application Tool that will help make this year’s application a breeze! If you are interested in learning more about this helpful tool, contact us here!