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malpractice insurance does not cover a hospital I see consults at


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Hi all,

I am a Cardiology PA and have worked at my current position since April 2018. I am employed by a hospital, but also see Cardiology consults at other outside hospitals too. This is part of my job and I am not paid extra for this and therefore never considered it moonlighting. My supervising physician goes to these outside hospitals too. I was recently looking over my malpractice policy declaration page because it is about to expire and asked my office manager if this covers the outside hospital I see consults at. She did not know so I called the number on the declaration page and they said they do not cover any outside facilites other than my employed hospital. I told them I go to these outside hospital as part of my job and they said the outside hospital can be added to my policy but I would need to get the approval of the hospital president first. And who knows how long that will take or if it will even happen. 

I reviewed my offer letter/contract and it states my employer will cover all work performed as a PA for them. It does not specify only at their hospital. So I feel like there is something legally wrong here.  Upon learning all of this, I am now on my supervising physician's malpractice policy, which covers all hospitals from now and onwards, but does not cover the past (april 2018 - dec 2020). I called CM&F to see if I could just buy coverage for that outside hospital from April 2018 - December 2020 but they said they cannot sell insurance for the past, but only for now and onwards. Their only suggestion to me was to get my current employer to add the outside hospitals to my current policy

So right now I feel stuck. My current employer HR team does not see the urgency or seem to care about adding those outside hospitals to my policy. And I also cannot just buy coverage myself because it’s for the past. I feel like my only option is to just move on, and if I am ever actually sued, then I would have to sue my employer for not covering me. 

Thoughts?

Edited by Graduate111
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42 minutes ago, Graduate111 said:

So right now I feel stuck. My current employer is too large with too much red tape and take the time and add these outside hospitals to my malpractice policy. And I also cannot just buy it myself. I feel like my only option is to just move on, and if I am ever actually sued, then I would have to sue my employer for not covering me. 

Thoughts?

I'm not sure what you mean by this.  If you are employed by a hospital system then there is a specific framework in place to manage these situations.  Contact HR. This a flagrant screw up on their part.  Do you have any colleagues that operate in the same fashion? Are they covered?

Only thing I can think of to save your rear end in the setting of a lawsuit would be holding up your contract and showing the line stating that you would be covered.  May be worth talking to an employment lawyer about.

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Start protecting your assets now...depending on the state there are different ways to do it and get ready to settle in for a long 10 year wait.  Hopefully you have not seen kids at the outside uncovered hospital or it will be up to 18.  Having said that...what an oversight.....lt should be shocking, but I see it happen every day to PA's.  Most just *trust* their employer to do the right thing which almost never happens.  They only find out they're hosed when the reaper comes calling.

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ugh

 

document, document document

 

send emails to HR clearly stating the lack of coverage and your contract stating that the employer provides coverage

they are likely not going to care - but if you create enough of an issue they might send a reply letter

document document document

 

any loss you might have (getting named in a suit) would open up the employer to liability as they did not provide malpractice for you per the contract - either way they are going to cover you

 

live and learn. have your own policy

 

CMF is expensive!

I pay about $2k a year, CMF quoted 6k for same coverage.......

 

Check out cinch or Mercer insurance

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Consult an attorney and have your attorney contact the hospital/HR/president. This isn't a trivial matter and you will be will served to spend some money on an attorney. They aren't worried about what you say but they will sit up and take notice if they get the idea they have a legal/liability problem. If you are harmed through their negligence and indifference they have a real liability problem.

Consult an attorney...today if possible. To them you are just an insignificant employee. Get their attention.

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4 minutes ago, sas5814 said:

Consult an attorney and have your attorney contact the hospital/HR/president. This isn't a trivial matter and you will be will served to spend some money on an attorney. They aren't worried about what you say but they will sit up and take notice if they get the idea they have a legal/liability problem. If you are harmed through their negligence and indifference they have a real liability problem.

Consult an attorney...today if possible. To them you are just an insignificant employee. Get their attention.

Yeah I agree with this 100%.  This could literally leave you financially devastated with no defense.  If you think a lawyer is expensive now, try retaining one to defend you should you get sued.  Also make SURE to get one who has experience in this sort of thing.

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Thanks everyone for the advice. I should add that this outside hospital is only less than 5% of the patients I see for the year. Also when I go to the outside hospital. I generally only dictate the note for my supervising physician and then he signs off on the note (I don’t sign the note most of the time). So my odds of getting sued are pretty low. I also really like my job (even though HR is super disorganized) and I’m worried having a lawyer write a letter to my employer would probably affect the status of my current job? My main concerned about this whole situation is that the outside hospital I go to requires I have malpractice insurance coverage for obvious reasons and if they find out that I did not have coverage for a period of time, then I can get in trouble with the outside hospital and it would go on my record somehow. 

Edited by Graduate111
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10 minutes ago, Graduate111 said:

My main concerned about this whole situation is that the outside hospital I go to requires I have malpractice insurance coverage for obvious reasons and if they find out that I did not have coverage for a period of time, then I can get in trouble with the outside hospital and it would go on my record somehow.

I would not be overly concerned about this.  But, if you are not overly concerned about a lawsuit then you need to push this HARD personally with your supervisor, HR, ANYONE who will listen.

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We counsel people every day about risks, and how to avert them.  Someone has a 7.7% risk of an MI in the next 10 years, I recommend a statin.  I recommend exercise to reduce the risk...of everything.  I advise people to quit smoking to reduce the risk of lung cancer and copd.  I advise people to stop with the cocaine.  

The reality is, the chance of something bad with these is minimal, but present.  We are bad at estimating our own risk.  We are inherently biased.  We focus on factors that are protective and tend to diminish the negative.  Thats why people come see us, so we can provide a impartial, unbiased review of their risk.

So...your risk is probably low, sure.  You might go through several lifetimes without anyone even looking twice.  However, on the flip side, if your number is up, and suddenly the feces hits the fan- its going to be bad.  

Also- recommending a lawyer is probably always a good idea.  Maybe I'm the odd one out, but it seems to me that getting entangled in a legal matter that takes years to disentangle is not something you want to do.  We've all seen people who peel off some sort of "salve" or other nasty thing from a wound, and ask why they didn't see a PA; I'm sure lawyers handle things all the time that a few dollars spent in the beginning would have saved a fortune.

 

 

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15 hours ago, MediMike said:

I'm not sure what you mean by this.  If you are employed by a hospital system then there is a specific framework in place to manage these situations.  Contact HR. This a flagrant screw up on their part.  Do you have any colleagues that operate in the same fashion? Are they covered?

Only thing I can think of to save your rear end in the setting of a lawsuit would be holding up your contract and showing the line stating that you would be covered.  May be worth talking to an employment lawyer about.

I have brought it to HR/practice operations attention but they are very slow with things. Basically told me they need to get it approved by the president of our medical group first before they can add it to my previous policy. Which I do not understand why because we have been going to these outside hospitals for years and the encounters are billed through our medical group. There is another Nurse Practitioner I work with but she is under my Supervising Physician's own malpractice insurance, which I am now under as of last month. Why they did not put me under his malpractice insurance from the beginning is beyond me. 

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1 hour ago, Graduate111 said:

I have brought it to HR/practice operations attention but they are very slow with things. Basically told me they need to get it approved by the president of our medical group first before they can add it to my previous policy. Which I do not understand why because we have been going to these outside hospitals for years and the encounters are billed through our medical group. There is another Nurse Practitioner I work with but she is under my Supervising Physician's own malpractice insurance, which I am now under as of last month. Why they did not put me under his malpractice insurance from the beginning is beyond me. 

Yeah that would be my question to them. "What is going to happen if I get sued after seeing one of these cases? My contract says ________ and you did ________"

Good luck!

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19 hours ago, Cideous said:

depending on the state there are different ways to do it and get ready to settle in for a long 10 year

I'm confused about this statement.  10 year wait?  Is that the statute of limitation somewhere?   My understanding is 2 years unless their is a death then 3 years.  At least in Mass.  

 

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16 minutes ago, Mayamom said:

I'm confused about this statement.  10 year wait?  Is that the statute of limitation somewhere?   My understanding is 2 years unless their is a death then 3 years.  At least in Mass.  

 

Yeah where I am at the status of limitations is 2 years

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It will vary from state to state. It is 2 years here as well unless the patient is a child and then it is until their 18th birthday.

It is a tough situation but I think, at the very least, you need to ask the question in writing and get the answer in writing. That will afford you some protection.

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4 hours ago, GetMeOuttaThisMess said:

BTW, it is not always two years from the date of occurrence either.  In some locales, it may be two years from the time that the individual should have been aware that there had been an error made (residual surgical sponge left in a body cavity for example).

True aaaaaand we circle back to consult a lawyer. There are a lot of variables in this story. I wouldn't bet my savings and future earnings and possibly my ability to earn on advice from.....well.....me.

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Agree with what's been said already. Get them to change it ASAP. If it's a hospital umbrella policy, sometimes they will just make it retroactive to your start date. Consult with someone if they can't make it retroactive. 

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15 hours ago, GetMeOuttaThisMess said:

For what it's worth, I applaud you for even having a copy of the declaration page.  I wish everyone else would take note of this and do the same.

This is SOOOO right.  Many places when you apply for credentialing and/or med mal coverage will want proof of med mal coverage from all prior employment.  It's soooo much easier if you can just email them images of the declaration pages from all of your prior coverage.

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On 1/8/2021 at 4:35 AM, Mayamom said:

This is something  that needs to be taught in school.  Risk management,  different policies, what to ask for.  Very important stuff.

If it was attempted to be taught in school, everyone would zone out/fall asleep

just not o verly exciting.

 

I do think there should be a "career" person in the programs that helps place students and ALL jobs should go though them for review (by the student/new grad choice)  yup to many areas where the employer tries to underpay

 

BTW - if the employment contract states they provide malpractice insurance, and they don't you can sue the employer for any losses that come out of not having insurance - due to this fact they will quickly make it right, as they really have no leg to stand on and you just need to make a formal request that consistent with your employment contract they need to provide insurance going forward and backwards

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Also

Just an FYI

As OTP comes about there is going to be A LOT more of this

 

People MUST get proof of insurance before starting first day of work.  Period - it is simple, you just refuse to do any clinical care till they produce proof of insurance.  Period, non variable.

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I can only say to things that pertain to you and your situation.

1. Every PA needs personal liability insurance that covers all of their acts in every hospital, moonlighting, etc. A personal law suit could cost you a hundred thousand dollars and if you lose, more. You need an occurrence policy.

2. I hate to disagree with Ventana has he is one of the sharpest PAs on this listserv but CM&F is not $66,00.00 for a cardiology PA. Surgery PAs are higher but yours would be much lower. Ask to speak to Will Sullivan, VP of new business with CM&F.

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8 hours ago, surgblumm said:

I can only say to things that pertain to you and your situation.

1. Every PA needs personal liability insurance that covers all of their acts in every hospital, moonlighting, etc. A personal law suit could cost you a hundred thousand dollars and if you lose, more. You need an occurrence policy.

2. I hate to disagree with Ventana has he is one of the sharpest PAs on this listserv but CM&F is not $66,00.00 for a cardiology PA. Surgery PAs are higher but yours would be much lower. Ask to speak to Will Sullivan, VP of new business with CM&F.

 

Not $66,00!

Did a quote again, $4400-$6800 is what it came up as for 1:3m PCP P1 or P3 (corrections for me) as below

 

image.thumb.png.32b8f6869a526fac1c168357536583ba.png

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