by Gerald Zarlengo, MD, Chairman & CEO, COPIC Insurance Company
Featured in the September-October 2020 Colorado Medicine Colorado Medicine.
Professional review is a key component that supports continuous improvements in health care. It is also an issue that COPIC has focused on with our legislative advocacy efforts. Last year, we worked with partners in the health care community, including the Colorado Medical Society, to maintain the legal protections of peer review when the Colorado Professional Review Act (CPRA) was renewed. Under Colorado law, physician practices that follow a formal professional review process have the same legal protections as peer review activities at a hospital or other health care facility.
Professional review activities that are privileged and confidential under CPRA include evaluating the competence, professional conduct of, or the quality and appropriateness of patient care provided by a physician, physician assistant (PA), or advanced practice registered nurse (APRN) employed by or under contract with the practice to provide health care services. This can range from routine reviews of cases identified through screening by quality indicators to addressing concerns about a possible impaired provider.
COPIC has developed templates to assist practices in establishing a formal professional review process through appropriate policies and procedures. These templates are consistent with the requirements for professional review under state and federal law. The templates should be reviewed by an attorney who can add information specific to the practice. The templates are also in a Word document format that allows them to be easily integrated and customized for your medical practice.
The following resources are available at
- An overview of the benefits of establishing a formal professional review process for physician practices.
- Professional Review Checklist that includes the steps a practice should consider when establishing a formal professional review process.
- A confidentiality agreement that should be signed by all professional review participants and be maintained on file.
- Templates of professional review policies and procedures for COPIC-insured practices to use:
- Professional Review Policy and Fair Hearing/Corrective Action Policy
- Practitioner Behavior Policy
- Practitioner Health Policy
COPIC’s COVID-19 information and resources
COPIC has posted an open-access COVID-19 page on our website at callcopic.com/covid-19-information-and-resources
We continue to update this information; here are some of the resources available:
- Details for COPIC policyholders that include:
- COVID-19 Physician Program, which provides temporary liability coverage to physicians who do not have other available insurance coverage, who are not currently a covered physician under a COPIC policy, and who will be providing professional services to a COPIC-insured practice or facility to assist with addressing COVID-19. The program has been extended through Dec. 31, 2020
- Risk management and legal/regulatory guidance on areas such as telehealth, reopening medical practices/resuming elective procedures, and recommended disclosures if caregivers test positive for COVID-19.
- A “special consent form” template that COPIC developed for elective surgeries and procedures performed during the COVID-19 crisis. The form complements standard consent forms, sets forth the information and risks associated with COVID-19, and when used in tandem with patient education materials, helps emphasize the importance of shared decision-making that underlines the informed consent process.
- COPIC’s HR Services, which offers guidance on employer/employee related issues such as understanding and ensuring compliance with the Coronavirus Aid, Relief and Economic Security (CARES) Act and the Families First Coronavirus Response Act (FFCRA).
- A summary of Colorado COVID-19 orders and guidelines released by governor executive orders and Department of Regulatory Agencies, Division of Professions and Occupations (DORA), as well as the state’s liability immunity laws.