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BA and liability - HITECH

Posted: Sep 04, 2013

I am going to try and post a link here and hope it works. This site gives a pretty simply explanation about HITECH and why the BA liability issue is coming up. It is not about misspelling words, transcribing wrong doses or any narrative in your document (E&O insurance)--it is about privacy of patient information (liability insurance) which most people can get through their homeowner's insurance agent. Good luck.

E&O insurance IS professional liability insurance - (see message)

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E&O insurance would be the professional liability insurance needed to cover the BA for being held liable for a privacy breach. It is just another term for professional liability insurance. People other than MTs and MTSOs have E&O insurance as well. In this case, the "error" in E&O would be the privacy breach. If one can get professional liability insurance under their homeowner's policy, that would be wonderful.

Nurses pay around... - (SM)

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Nurses pay around $50 annually for professional liability insurance. I have not looked into what it costs for MTs, but I have heard it can be considerably higher for some reason. Nurses' E&O insurance covers them for privacy violations as well as other nursing-related malpractice issues. The policies are typically in the range of $1,000,000 to $6,000,000 for them. It is recommended they have it even though they are typically covered under the hospital or practice policy.

They get it thru their union or association - Not their homeowner ins agent

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My sister sells this type of insurance and specializes in E&O. Minimum premium is usually 750 to 1500 dollars for a policy such as this. It's not the type of insurance a regular agent sells. They can get it for you but they have to go to a wholesale broker like my sis. If nurses pay only 50 per annum then they are getting a policy through their union or nursing association.

As for the reason they are recommended to have it, say for instance they're at coffee one morning with friends and MaryAnne says she has this problem, and what does Ginger think it is? Ginger gives her opinion, because they're just having coffee, right? MaryAnne's problem turns out to be much worse than she let on to Ginger, and she ends up losing a limb to gangrene and sues Ginger. Since this was not in the office or hospital setting, Ginger isn't covered by her employer's insurance but she has her own policy that will provide defense.

My homeowner's agent - Old Pro

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does not sell E&O. I no longer need it, but I just asked out of curosity. He said he could refer me to a special agent who would sell it to me, but since I am out of the line of fire, I didn't need it, just thought I would ask. Whoever thought transcription would become so complicated? I feel sorry for those not yet old enough to retire, I really do. Good luck to you all!

My homeowner's agent - confused

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But can you buy personal liability insurance through your homeowner's agent? If you are the only person working for your company (IC/BA) why can't you use a simple 1 million dollar personal liability insurance to CYA? Just wondering if when we call it E&O if the price doesn't go up?

personal liability is not professional liability - personal liaibility is AKA an umbrella policy

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Personal liability is also known as an umbrella policy. It's designed to kick into place if your homeowners or auto policy limits are exhausted. If someone has a lot of assets to protect, the umbrella policy is very importance.

Think of your auto, homeowners, and possibly business general liability policies all in a row. The personal liability/umbrella policy covers all of them like...you got it, an umbrella.

If someone injures themselves on your property and sues you for a million dollars and wins, say your homeowner's policy has a limit of $500,000. Once that is paid out, then the umbrella policy kicks in for the remainder.

E&O aka professional liability provides defense if you make an error or omission in the course of your work for a client that causes financial harm to them in some way. Here's the rub, though, a lot of E&O policies have not kept up with the times and many times technology-related claims are specifically excluded. You would have to be very careful to make sure you got one that included technology breaches, as that is the basis of all the requests for the E&O going on now.

The other thing to keep in mind is that once you have E&O, you really can't ever have it lapse. E&O insurance is on a "claims made" basis rather than an occurrence basis like regular liability insurance. If someone gets hurt falling over the door in your house, you know exactly when that incident happened. That's an occurrence.

With professional liability, the nature of the damage may not be known for a while, i.e., if you're an MT and you allow a breach of information that is then used against someone but it takes a year and a half to go figure it out and trace it back to where the breach occurred. The coverage is then based on when the claim is made, rather than when the error occurred.

It's all confusing, and I still think that the regular MT who is acting as a subcontractor to the MTSO should be covered by the MTSO's insurance. This really should make any MT think twice about acting as a contractor for an MTSO.

The E&O issue - Alice

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My RN professional liability insurance is $108 per year for employee and maybe more than that for self-employed. It is purchased from a company called NSO that has a website. Here is what is written on their website:

"This coverage is underwritten by the American Casualty Company of Reading, Pennsylvania, a CNA company, one of the nation's leaders in professional liability insurance."

They don't seem to offer E&O insurance for MTs, but maybe they will expand into this area. Maybe they aren't even aware of our need for it.

This is my quote for insurance - Karla

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Called yesterday, $2,000. Got the business associate form to sign now and nowhere does it mention obtaining liability insurance. In fact, seems quite similar to what is signed on a regular IC contract.

Seems a bit high - for the little MT

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Wow. That seems kind of steep for the MT working at home as a subcontractor. I wonder what the association rate is for members of AHDI through Seabury and Smith?

It is actually a pretty standard quote for basic - E&O insurance

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I'm the one up above who said my sister sells this type of insurance. It's a pretty standard quote, if a smidge on the high side, but not by much.

NSO - Nurse Service Organization - You are part of a large group this way

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If they did offer something like this to MTs, that would be great. I still don't think the regular MT who is subcontracting to an MTSO needs this, as the MTSO insurance would/should cover any breach that is made. This should be the death knell of using MTs in this way when they are really employees.

An MT who is truly a contractor, i.e., working directly for the doctor or provider, should have this. As a professional business person, you always want to have professional liability insurance to cover your assets. It's a deductible expense and it's one that needs to be taken into account.

MTSO coverage for MTs questionable - breach from your workplace

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I can see why the MTSO wouldn't include the IC/BA if you are a remote worker. The MTSO cannot control your end of the process when it comes to how you do your work. The MT would be responsible for the correct internet connection/safeguards, who comes and goes in your home/office or uses your computer, or if your computer were to be stolen from your home. These things are totally in the control of the BA and that is why the liability is extending its reach. Just sayin!

I think you are right - things are tightening up

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Now with HITECH, the BA can certainly be penalized as well. I have often thought about how loosey-goosey it is with regard to PHI having all these work-at-home MTs, although I have never seen any breaches documented from a work-at-home MT. Has anyone else?

Nothing gets stored on my computer. I subcontract with an MTSO, and the system is set up so that when the report is sent, it is encrypted and is erased from my computer along with the voice file, and I can never get it back. I don't have any access to the EMR that stores patient data (our reports are uploaded to an EMR). The only breach I can think of coming from my end would be if someone read a report I was working on while I had it open on the computer (not likely given it is just me and my husband living here) or if I personally copied down patient information for some nefarious reason. It would be a tough pill to swallow to have to come up with 2K for E&O insurance, but I could put it down as an expense since I am not an employee.

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