On February 2, 2023, the Health Resources and Services Administration (HRSA) published Program Assistance Letter (PAL) 2023-01, Calendar Year 2024 Requirements for Federal Tort Claims Act (FTCA) Coverage for Health Centers and Their Covered Individuals. This PAL describes the deeming requirements for health centers for CY 2024, setting a deadline of June 23, 2023, for submission of redeeming applications. “Eligible entities that do not submit a redeeming application by the deadline may experience a gap in FTCA coverage and may wish to consider purchasing private malpractice liability insurance for CY 2024” (PAL 2023-01).

New applicants may submit an initial deeming application at any time the Electronic Handbook (EHB) is open to accept applications. HRSA will communicate dates when the EHB is closed for maintenance. We recommend new applicants who wish to be deemed for CY 2024 submit applications early enough for HRSA to complete its review (i.e., no later than October 1, 2023).

The deeming application for CY 2024, while similar to prior years, has some changes that health centers must be aware of before submitting their deeming applications:

• All health centers must provide obstetrics risk management training to all clinical staff who may have contact with reproductive age patients, regardless of the method they use to provide obstetric services in their health center (or even if they don’t provide any obstetric services at all).
• The annual risk management report to the governing board cannot be a compilation of quarterly risk management reports but must be a distinct report prepared as an annual summary of risk management activities and progress.
• The Quality Improvement/Quality Assurance section of the deeming application continues its reliance on attestations, without requiring the upload of any documents.
• The credentialing process now requires health center to verify “any other credentialing information required by law to be completed for health care providers.”
• Credentialing and privileging must be completed at least every two years.
• The EHB credentialing list includes a new data element, “most recent privileging date.”

HRSA is required by law to make a determination on the deeming application within 30 days after receipt. Deeming applications will initially be reviewed for completeness. If additional information or clarification is needed, the health center will be notified by HRSA and the health center will have 10 business days to supply the requested information. If the review of the deeming application results in a determination that the health center has not demonstrated that it meets the FTCA requirements and is in danger of being disapproved, HRSA will notify the health center via a “compliance notice” outlining the deficiencies and give the health center 30 days in which to respond. A final decision on a health center’s deeming application will be transmitted through the EHB.

If you have any questions regarding the FTCA deeming application process or need assistance with the deeming application, please contact Martin Bree at mbree@feldesman.com or 202.466.8960.

Mr. Bree is a member of the New Jersey Bar and is not licensed in Washington, DC. His practice is limited to federal health care matters.