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You have questions. We have answers. Our Frequently Asked Questions section makes it easy to find what you’re looking for. If you have a concern that is not addressed below, please feel free to email us. 


While HPSO takes great care to ensure that the FAQ information is accurate, such information cannot be interpreted as changing the scope of the insur​ance terms and conditions of your current policy. A policy can only be changed by the underwriter through a change in coverage form, endorsement to the policy contract, or amendment to the policyholder's certificate of insurance. The underwriting rules issued by the company may change from time to time which may affect the questions and answers that follow. Coverages may differ in some states.


Overview

There is no direct exclusion in your professional liability policy through HPSO for communicable diseases like the Coronavirus. If you feel you have a claim that’s related to the providing of professional services and a patient being diagnosed with or infected by COVID-19, you should contact us so that we can review your claim and determine if coverage applies to your specific situation. We are unable to answer hypothetical “what if” questions as each claim must be evaluated on its unique facts and circumstances, as well as policy provisions and the allegations of a claim, in order to determine if coverage will apply.


We’ve developed the following for our individual policyholders, which generally discuss the relevant issues.

 


*Note:  Insurance companies issue insurance policies that specify definitions of key policy terms, triggers for coverage applicability and exclusions to the policy.  Each claim is evaluated by the insurance company that issued the policy.  The claim is evaluated with respect to policy provisions in order to determine coverage applicability.​

Search for a specific keyword or browse our most commonly asked questions below. 



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I am not currently practicing due to COVID-19 business closures but I have an active policy with HPSO. Should I update my policy?

It is important that you are covered appropriately during this unusual time. Depending on your situation you may want to change the status of your policy to part-time or even move into our “Leave of Absence” policy. Please call 800-982-9491 to discuss what is best for your specific situation.

I currently have a “leave of absence/retirement policy” with NSO. With the COVID-19 pandemic, I’ve been asked to come back to work. Do I need to update my policy?

Yes, it is important that you are covered appropriately during this unusual time. You will want to update your policy status to “professional”. Please call 800-982-9491 or email us at service@hpso.com to make this policy change.

Can you please list screening questions to determine the risk of homebound patients that can pose a threat to providers?

The best source of information related to the prevention and treatment of COVID-19 is the CDC. Within the CDC’s guidance, we recommend the following resources:

- For infection prevention recommendations, the CDC has developed interim guidance for infection prevention and control specific to COVID-19.

- The CDC has developed Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization.

- The CDC has guidance that is intended to address recommended infection prevention and control practices when these activities are performed at a home, which warrant additional considerations beyond those described for healthcare settings. This guidance includes interviewing and assessing persons with or without symptoms.

Because the onset, duration, and period of infectiousness for COVID-19 are not yet known, healthcare providers in every healthcare facility should take precautions, both in and outside of health care settings, to minimize the potential for transferring and contracting this illness. The CDC will update this interim guidance as needed and as more information becomes available.

As an older healthcare provider who may have a a higher risk of contracting Covid-19, what are your recommendations for my safety?

While older adults may be at a higher risk for developing more severe illness from COVID-19, no population or healthcare provider is immune. We recommend that all providers, staff, and patients exercise extreme precaution both in and out of the hospital environment to minimize the potential for transferring and contracting this illness. The best source of information related to the prevention and treatment of COVID-19 is the CDC. For infection prevention recommendations, the CDC has developed interim guidance for infection prevention and control specific to COVID-19. This guidance is the best, most up-to-date information available.

I have a homebound patient with an upper respiratory infection. If my client or a family member of my client, is diagnosed with COVID-19; what is the company’s responsibility to me and my patient as well as my responsibility to the patient?

The best way to address your questions and concerns at this time is to direct you to the best sources of up-to-date information and assistance: The best source of information related to COVID-19 is the CDC. For guidance, the CDC has developed interim guidance for healthcare providers who are coordinating the home care and isolation or quarantine of people confirmed or suspected to have COVID-19, as well as interim guidance for infection prevention and control. Further, the FDA would be the best source of information regarding PPE supply shortages, and reporting shortages.

As far as your company’s responsibility to you, employers of healthcare workers are responsible for following applicable OSHA requirements, including OSHA's Bloodborne Pathogens (29 CFR 1910.1030), Personal Protective Equipment (29 CFR 1910.132), and Respiratory Protection (29 CFR 1910.134) standards. See OSHA’s Standards page for additional information on OSHA requirements, or review OSHA’s recommendations specific to COVID-19: https://www.osha.gov/SLTC/covid-19/controlprevention.html#health

To get OSHA advice, file a complaint by phone, or report an emergency, contact your nearest OSHA office, or calling OSHA toll-free at (800) 321-OSHA (6742).

For additional resources and guidance, we recommend the following resources:

- ECRI: Offer checklists, equipment recommendations, alternate suppliers, and infection control guidelines.

- ANA: What nurses need to know about the coronavirus and best practice resources, as well as ethical standards.

- WHO: Rolling updates on COVID-19.

Do you have any recommendations for patients, staff and visitors entering our facility?

Because the onset, duration, and period of infectiousness for COVID-19 are not yet confirmed, employers and healthcare facilities should take the stance that screens are necessary to “mitigate risk.” All patients and visitors entering any healthcare facilities can and should expect to be screened. Facilities may choose to communicate this to visitors and patients by placing signs, sending letters, or stating this verbally with each appointment, to manage expectations.

Facilities should have a process is in place to triage, report and track patients, visitors, and staff who screen positively for COVID-19. Those individuals will also be taken through a complete protocol that helps them and protects staff and others.

While providers may encounter folks who do not wish to be screened, during this time of a national emergency and pandemic, they should not waver from established facility policy and direction from the CDC. If an individual refuses to allow screening, and is not in an emergent condition or status, I would refuse treatment and offer to reschedule that patient until they comply with protocols or the national emergency status has been lifted.

The CDC has guidance that is intended to address recommended infection prevention and control practices when these activities are performed outside of a hospital setting, which warrant additional considerations beyond those described for healthcare settings. This guidance includes interviewing and assessing persons with or without symptoms.

Can you address refusing a patient when the facility is out of PPE? Or reusing masks?

We encourage healthcare providers to use their professional judgment to determine when, where, and how to provide care, with the understanding this is not the optimal environment for care, for anyone involved. Given how quickly the situation around the novel coronavirus (COVID-19) is evolving, we suggest following your facility’s policies and procedures, CDC guidelines and the advice of local, state and federal health authorities regarding the following to best protect yourself and your patients / clients during this public health emergency.

For additional resources and guidance, we recommend the following resources:

- ECRI: Offer checklists, equipment recommendations, alternate suppliers, and infection control guidelines.

- US Department of Health and Human Services (HHS): Routinely monitor for federal government updates related to the provision of telehealth services, diagnostic testing, and vaccine trials.

- WHO: Rolling updates on COVID-19.

Information and resources are constantly changing so we suggest checking back in on a frequent basis. Your employer policies and procedures, if available, may also have unique information on this topic for emergency situations like you’ve described.

Should we be seeing preventative procedure patients?

CDC guidelines recommend rescheduling non-urgent or elective procedures / treatment as necessary, and eliminating patient penalties for cancellations and missed appointments related to respiratory illness. Guidelines also note that if urgent treatment is necessary, providers need to determine appropriate precautions to take on a case-by-case basis to avoid spreading diseases among patients, visitors, and staff. Symptomatic patients who need to be seen in a clinical setting should be asked to call before they leave home, so staff are ready to receive them using appropriate infection control practices and personal protective equipment. These guidelines through the CDC and otherwise are continuously adapting so we encourage you to check back frequently.

What recommendations do you have for conducting telehealth across state lines?

First, telehealth treatment/services, practitioners may need to be appropriately licensed/certified/credentialed to practice in the state where the patient is located, and work under that state’s scope of practice. HPSO does not exclude telehealth/telemedicine coverage provided you are working within the appropriate regulations and scope and standards of practice. Please refer to your professional association, state and/or federal government standards and requirements for more information about scope/standards of practice.

A patient-provider relationship can be established via telehealth in a similar manner in which it is established in an in-person office/hospital setting. However, some state laws restrict the setting in which a patient must be located in order to establish a patient-provider relationship (for example, limiting it to “established medical sites”), the modalities that can be used to establish such a relationship (such as via telephone or audio/video technology), and the types of services that can be provided via telehealth (especially as it relates to prescribing). It is advisable to review the relevant state practice act(s) as well as established professional standards prior to offering telehealth services. If a state practice act is silent regarding telehealth or published opinions, or interpretations regarding the subject of telehealth have not been issued by recognized sources, then contact the state professional licensing board for clarification.

Do you have recommendations for caring for patients who are Medicaid insurance carriers?

The COVID-19 pandemic represents a dynamic challenge to the health care system, and as a result new guidance is being provided continuously. In general, telehealth reimbursement policies differ greatly across state Medicaid plans and private payers, and the Centers for Medicare and Medicaid Services’ telehealth coverage reimburses only for specific services when they are delivered via live video and is limited to strictly defined rural areas, for specific services, and when the patient is located in a specified health care facility by certain providers. However, over the last several weeks, the HHS Secretary has been granted the authority to allow telehealth to be more widely used for Medicare beneficiaries during the COVID-19 public health emergency period. CMS has also issued guidance so states can request a waiver of additional specific provisions under Medicare, Medicaid and CHIP to improve the health care response to COVID-19. It is advisable to check with your state Medicaid office for up-to-date information regarding the provision of telehealth services, including distance counseling, and to monitor US Department of Health and Human Services (HHS) website for federal government updates related to the provision of telehealth services.

What are the rules for using the telephone or video for conducting telehealth?

It is important to keep abreast of the changing dynamics and guidelines as they are being rapidly modified to address the changings needs of providers and their patients. Telehealth services must comply with the same HIPAA-related rules and regulations at the federal and state levels, as well as business policies, that apply to the delivery of in-person services. According to the FCC, if a patient provides a contact telephone number to a healthcare provider, the provision of that telephone number constitutes express consent for telephone calls to be made, subject to certain HIPAA restrictions. Consent applies to calls and text messages related to the provision of medical treatment.

To ensure that the technology is compliant with HIPAA rules and regulations, practitioners should be conversant with the HIPAA Breach Notification Rule and technology encryption requirements. In the case of interstate practice, if requirements for privacy, security and informed consent differ between states, practitioners are encouraged to follow the most restrictive laws and regulations.

There are many HIPAA-compliant telehealth solutions. HPSO does not endorse any specific brand. Rather it is the responsibility of the provider to determine which option is both legal, cost effective, and available in their state and area of practice. Here are names of a few options in no particular order: Doxy.me , thera-LINK, TheraNest, SimplePractice, Zoom for healthcare, and VSee. We also recommend you contact your professional association to see what they may recommend to fit your needs.

Some resources that may be useful to you as you offer more distance counseling:

- Healthcare Perspective: Telemedicine

- Counselor Spotlight: Telebehavioral Health

- American Counseling Association (ACA): ACA Code of Ethics, Section H, Distance Counseling, Technology, and Social Media

- CMS: HIPAA for Professionals

Who is considered “essential healthcare"?

While we cannot make the determination of which healthcare providers are essential or non-essential, we recommend you discuss this with your employer or professional state organization to get clarification on essential functions that may be appropriate for you to maintain operations and to protect your health and safety at this time.

For healthcare providers who are deemed as essential, we are reminding and recommending that providers, patients, and the public exercise extreme precaution, both in and outside of health care settings, to minimize the potential for transferring and contracting this illness. The best source of information related to the prevention and treatment of COVID-19 is the CDC. For infection prevention recommendations, the CDC has developed interim guidance for infection prevention and control specific to COVID-19.

My mental health clinic has banned seeing patients in the office. I need to conduct sessions on the phone or via video conferencing. I’m not really tech savvy. What are my liability issues?

If you are considering providing your professional services via telehealth, please know that the professional liability coverage, issued by HPSO, does not have a limitation as to how professional services are provided (in person or via technology). Rather, the policy requires that you are appropriately licensed to provide professional services and that you comply with state, federal and facility guidelines relative to scope of practice and practice setting. HPSO has developed a telehealth risk education piece that includes several resources for you.

What procedures and protocols should be used to reduce the risk of spread of COVID-19? I am seeing same towels and electrical stim pads being reused.

HPSO encourages physical therapists, practice staff, patients, and the public to exercise extreme precaution, both in and outside of health care settings, to minimize the potential for transferring and contracting this illness. The best source of information related to the prevention and treatment of COVID-19 is the CDC. For infection prevention recommendations, the CDC has developed interim guidance for infection prevention and control specific to COVID-19. Additionally, the American Physical Therapy Association (APTA) has developed a resource outlining best practices for preventing pathogen transmission in physical therapy clinics.

As recommended by the CDC, if you or any other provider think they have been exposed to COVID-19 and develop a fever and symptoms, such as cough or difficulty breathing, they should call their healthcare provider for medical advice. If you develop any emergency warning signs for COVID-19, seek medical attention immediately.

For additional resources and guidance, we recommend the following resources:

- APTA: What physical therapists need to know about the coronavirus and best practice resources.

- ECRI: Offer checklists, equipment recommendations, alternate suppliers, and infection control guidelines.

- WHO: Rolling updates on COVID-19.

Am I covered for incidents related to COVID-19?

There is no direct exclusion in your professional liability policy through HPSO for communicable diseases like the Coronavirus. If you feel you have a claim that’s related to the providing of professional services and a patient being diagnosed with or infected by COVID-19, you should contact us so that we can review your claim and determine if coverage applies to your specific situation.

Am I covered for Telehealth/Telemedicine?

If you are considering providing your professional services via tele-health, please know that the professional liability coverage, issued by HPSO, does not have a limitation as to how professional services are provided (in person or via technology). Rather, the policy requires that you are appropriately licensed to provide professional services and that you comply with state, federal and facility guidelines relative to scope of practice and practice setting.

What should I know about HIPAA, Patient Privacy and Confidentiality for Telehealth/Telemedicine?

Always adhere to HIPAA regulations which include the Privacy, Security and Breach Notification Rules as well as the HITECH Act. Keep in mind that additional state and federal requirements under patient privacy standards apply, and these requirements do not change when practicing Telehealth/Telemedicine (e.g., behavioral health, alcohol/drug treatment and minors). It is the provider’s responsibility to be appropriately equipped to perform services. Any questions regarding HIPAA or patient privacy regulations, please refer to the HHS website for guidance for providers: https://www.hhs.gov/hipaa/for-professionals/index.html

How can I best think about protecting myself, other providers, other patients – in an outpatient non-emergent/non-urgent care setting?

The CDC guidelines, which may be accessed at: https://www.cdc.gov/coronavirus/2019-ncov/index.html, note that when a patient presents with symptoms of an infection (e.g., fever, cough and shortness of breath), providers may consider postponing non-emergency/non-urgent or elective procedures / treatments until the patient is no longer contagious. If urgent treatment is necessary, healthcare providers should take appropriate precautions in order to avoid spreading COVID-19 among patients, visitors, and healthcare facility staff.

How should I handle documentation in emergency/disaster situations?

Appropriate and complete patient/client documentation is vital in healthcare for a variety of reasons. Providers should follow their facility’s policies and procedures on patient/client documentation during emergency/disaster situations. Notably, during emergency/disaster situations appropriate patient/client documentation is most critical. Typically, an emergency/disaster situation would not represent an effective deterrent or defense in the event that a lawsuit arises.

Does having my own individual professional liability insurance policy make me a more likely target for a lawsuit?

No, having your own professional liability insurance coverage does not make you a more likely target for a lawsuit. When something happens and a patient is injured, most attorneys will name everyone who was involved in the patients' care in the lawsuit—whether you have your own coverage or not.

Why do I need an individual professional liability policy? Won't my employer's insurance policy cover me?

Professional liability insurance safeguards you against allegations of malpractice. While your employer may provide coverage for you, it may not be enough to cover you in all cases. Your employer's policy is designed to preserve the employer’s needs and interests first.

Will my policy provide coverage if I'm assaulted on the job?

If you changed your place of employment, your professional liability insurance premium is unaffected. However, if your new employer is in another state, there is a chance your rate could be impacted, either up or down. If you change what type of work you do, your premium could also be affected. For example, if you were employed and became self-employed the cost for a self-employed policy is more expensive, because now as a business owner you are taking on additional responsibilities, that can incur greater risks.

I just changed jobs. Will I have to pay more for my liability insurance?

If you changed your place of employment, your professional liability insurance premium is unaffected. However, if your new employer is in another state, there is a chance your rate could be impacted, either up or down. If you change what type of work you do, your premium could also be affected. For example, if you were employed and became self-employed the cost for a self-employed policy is more expensive, because now as a business owner you are taking on additional responsibilities, that can incur greater risks.

What is the difference between occurrence and claims-made coverage?

An occurrence policy provides coverage for a claim that occurs during the policy period, regardless of when the claim is reported.

For example, let's assume you carried a malpractice policy from December 1, 2012 to November 30, 2013 and it was an occurrence policy. You never renewed the policy. On June 16, 2014 you receive notice that you were named in a malpractice lawsuit for something that happened on February 4, 2013. Because the incident occurred during your coverage period, you would be covered for that claim, even though you received notice of the claim after your policy ended.

A claims-made policy provides coverage for an incident that occurs during an active policy period only if the claim is also filed during an active policy period.

For example, let’s assume you had a claims-made policy from December 1, 2012 to November 30, 2013 and you did not renew that policy. On June 16, 2014 you received notice that you were named in a malpractice lawsuit for something that happened on February 4, 2013. You would not have coverage under your claims-made policy because your coverage was not active when the claim was made.

If you own a claims-made policy, give some additional thought before you decide to cancel or non-renew your policy. If you decide to end a claims-made policy, you can purchase "tail" coverage. Tail coverage will extend the time that a claim can be reported, but the incident will still need to occur while the policy was active.

If you are not sure whether your policy through NSO is occurrence or claims-made, please email us or call us with your policy number, and we'll confirm your coverage for you.

I'm starting my own company. Do you have a policy that will cover my company for malpractice?

Yes, NSO offers professional liability insurance to nursing firms, providing many of the same coverages our individual program offers. Our coverage can be tailored to meet the specific needs of your firm. Click here for more information on our affordable liability coverage for nursing firms.

I just received a copy of my certificate of insurance. I am currently listed as an LPN, but I am now an RN. What do I need to do to change my certification?

To change the licensure on your policy, simply send us an email about the change and include your name and policy number. We will update your policy and send you a revised Certificate of Insurance. Your rates and benefits will be the same.

I have an active license, but I am not going to be working for a while. Should I keep my coverage active?

If you plan on keeping your license active, you have a responsibility to anyone to whom you give advice, any place you volunteer, and any situation that requires emergency care. Your nursing license needs to be insured at all times. One option is to take advantage of our Retirement/Leave Discount, which can include family leave, change to a non-nursing occupation, retirement, or disability. This discount offers limited coverage at 50% off of our full-time nursing premium. All you need to do to change your licensure on your policy is send us an email outlining your particular situation. Be sure to include your name and policy number.

How do I upgrade or reduce my insurance coverage (limits of liability, hours I work per week, etc.)?

We ask that any coverage change you would like to make to your policy be requested in writing. If you would like to request to change your coverage, you can email us. Be sure to include your name, address, policy number, and requested change. If you would like to know if there is a change in your annual premium based on your coverage change, you can call 1-800-247-1500 and we will help you to proceed. Please note that in any case, we will not be able to change your coverage until we have received the appropriate additional premium. Any refund of premium, if one is due, will be sent to the address on the policy, so be sure to include your current address in the request.

How do I cancel my policy?

If, after careful consideration, you determine you would like to cancel your policy, you can do so by submitting a written request to cancel by fax or mail. Your policy will be canceled based on the date we receive your notification or your request. If you are eligible, you will receive a refund of any unused premium within two weeks of our processing your request. Before you cancel your policy, there are a few things to keep in mind. If you are cancelling because you are temporarily leaving your position, we can offer you a 50% discount on your premium and adjust your coverage. This will allow you to have the professional liability coverage you need while maintaining an active license. Also, if you are covered by an employer's plan, be sure that you understand the coverage before you cancel your individual coverage. Your employer's policy provisions may differ in ways that will leave you under-insured. Check to see if your employer will provide each of the benefits that our policy provides.

Do I need to create a login and password if I just want to renew my policy?

No you don’t. By clicking on the Renew Now button, you can simply make a payment without requiring a login or password. You’ll need your policy number and zip code for verification. However, for security purposes, if you would like to make any online changes to your policy such as a professional or address change, you’ll need to use our My Account tool.

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