COPIC Comment:

Thursday, September 01, 2016 12:33 PM
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Legal expertise that supports the practice of good medicine

by Ted J. Clarke, MD, Chairman & CEO, COPIC Insurance Company

Navigating health care often requires that medical decisions take into account the ever-evolving legal and regulatory environments. In complex situations, medical providers look for guidance to answer questions like “what are the rules surrounding telehealth interactions with patients?” or “what type of consent is required for drug screening in the perinatal setting?”

Members of COPIC’s in-house legal department are recognized for their expertise on issues where medical and legal elements intersect. They play an integral role in how we support our insureds, the medical community and broader efforts to maintain a stable medical liability environment.

Guidance on legal issues
Working closely with COPIC’s Patient Safety and Risk Management staff, the legal team answers questions from insureds to help them understand a wide range of issues such as:

  • HIPAA
  • Problematic patient situations
  • Treating minors
  • Medical board reporting and policies
  • Termination of patient care
  • EMTALA

The legal department also shares its knowledge by authoring articles for COPIC newsletters as well as conducting educational presentations on current health care topics.

Providing input on regulatory issues
The legal department is at the forefront of maintaining relationships with the Colorado Medical Board, Department of Regulatory Agencies and other administrative entities. This has helped establish COPIC as a trusted resource. Members of the legal team provide opinions, review suggested language, and testify regarding proposed rules and policies that affect health care providers. In the last several years, areas of involvement have included:

  • Telemedicine and liability issues
  • Supervision requirements with allied health professionals
  • Prescription drug opioid policy

Maintaining a favorable legislative environment
Throughout the year, the legal team reviews legislative bills for impacts on patient care, encroachment upon tort reform, and unnecessary increases in medical and health care facility liability. In 2016, input was provided on more than 50 proposed, amended or drafts of health care-related legislative bills.

In addition, legal staff may draft language, attend stakeholder meetings and testify on key legislation affecting health care providers. As appropriate, these efforts are coordinated with partners such as the Colorado Medical Society and Colorado Hospital Association and, in recent years, have included:

  • Colorado Professional Review Act
  • Prescription Drug Monitoring Program
  • Emergency Medical Services Quality Management Bill

Managing “covered proceedings”
COPIC’s “covered proceedings” coverage (formerly referred to as “legal defense”) is part of our medical professional liability policies. The legal department oversees this coverage, which is for issues that involve defense costs for disciplinary proceedings, governmental investigations, billing fraud and abuse investigations, or peer review proceedings where the insured is under the formal review of a peer/professional review entity.

Additional areas of support
The in-house attorneys who are part of our legal department do not directly represent insureds facing a claim or lawsuit (our claims department works with outside defense counsel on this), but they do participate in our Claims Committee meetings and provide ongoing support tied to our coverage. In addition, they are involved with our popular “mock trial” program – an education activity where trials of de-identified cases are re-enacted to offer insight into the litigation process.

COPIC’s legal team contributes to better patient care in several meaningful ways. Their dedication to support medical providers and patient safety is essential as the future of medicine unfolds and new challenges emerge that require their expertise.


Posted in: Colorado Medicine | Practice Management | Legal and Ethics
 

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