Medical Malpractice Questions 2012 Physician License Renewal Application

Medical Malpractice Questions 2012 Physician License Renewal Application
 
VMS has been contacted by a number of physicians about the malpractice questions on the Vermont Board of Medical Practice’s (VBMP) license renewal application for 2012.   VMS members have raised two issues.  First, Question 111 on the renewal form asks if licenses have “ever been involved in a Medical Liability Claim” and seems to require physicians to submit detailed information (Form A) about cases that were dropped, dismissed or never formally filed, and that did not result in payment.  Historically, the VBMP has required reporting of information about pending claims and claims that resulted in court judgments, arbitration awards or settlements, but not about claims that were withdrawn, dismissed, or dropped without filing and without payment on behalf of the licensee.  Note: settlements subject to reporting may include pre-filing settlements based only on a demand. 
 
The second issue is that the renewal application requests information about ALL malpractice claims, including older cases dating back 25 or 30 years.  This has created problems for physicians since, in many cases, the documentation needed to provide the specifics of these cases is no longer available.   Hospital medical staffs and defense counsel have purged their records.  These are cases that physicians reported previously to the VBMP. 
 
With respect to the first issue, the VBMP has told VMS that they only intended to require reporting about settlements, judgments, awards and pending claims – not cases where malpractice was alleged and then subsequently the case was dismissed or dropped, or cases that were never formally filed.   For the 2012 license renewal, physicians are only required to report currently pending claims, and claims that resulted in settlements, judgments, or awards.  Similarly, physicians are only required to complete Form A with respect to currently pending claims, and claims that resulted in settlements, judgments, or awards.  Note: settlements subject to reporting may include pre-filing settlements based only on a demand. 
 
The VBMP agrees that the wording of Question 111 is confusing and will work on clarifying it before the next renewal cycle in 2014.   The Board told VMS that they added Question 111, in order to include a question that generates a “yes” or “no” answer for the new electronic system.  Because the system determines work flow based on certain “yes” answers, the VBMP wanted to create a question that would trigger a review of the malpractice section. The malpractice questions from the 2010 and 2012 renewals and Form A are attached above.  If a malpractice case does not meet ANY of the following criteria, physicians may answer “no” to Question 111 and are not required to complete Form A :
1.      The case is not currently pending;
2.      The case did not result in a judgment, settlement, award, or pre-filing settlement based on a demand; and
3.      The case did not result in a payment to a patient. 
 
With respect to the second issue, the VBMP asserts that it is not limited to looking back only 10 years and believes it is required to look at the entire malpractice history when carrying out its public protection mission.  The renewal questions must be formally approved by the Board and the VBMP states that it is too late to change the questions in this cycle, even if the Board were to determine that 10-year reporting was adequate for public protection.  

The VBMP staff note that the question has not changed since the 2010 renewal.  VMS has heard from members that it can be impossible to get this old information because generally no one keeps it longer than 10 years.  Hospital medical staffs and defense counsel have purged their records.  Physicians are trying to get the best information they can about the older cases to file with their renewal applications.  The VBMP states that it may be willing to revisit the requirement to report old cases prior to the next license renewal or to clarify it in the rulemaking process, but the requirement to report older cases remains in place for the 2012 renewal. 

The VBMP requirement to report all malpractice cases, including cases older than 10 years, is inconsistent with both the Vermont profiling law cited by the VBMP on the renewal application, 26 V.S.A. § 1368 (a)(6)(A), and the CAQH credentialing form that is mandated by Vermont law to be used for hospital and insurance credentialing. 
 
The physician profile law in Vermont only requires physicians to report malpractice judgments, settlements, awards that resulted in payments during the last 10 years.  http://www.leg.state.vt.us/statutes/fullsection.cfm?Title=26&Chapter=023&Section=01368  
 
The CAQH application form only requires information about pending, arbitrated, mediated or litigated claims within the past 10 years.   The malpractice question is on page 17 and the supplemental form is on page 35. http://caqh.org/pdf/CAQH_Provider_Applicationv5_2006-10-31.pdf
 
Please contact VMS if you have questions or suggestions. 

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