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Published Online: 16 September 2005

Administrative Action Coverage Needed For Defense Against Complaints

Q. Within the next year, I will be starting a private practice and am now choosing a medical malpractice insurance policy. I noticed that coverage for administrative actions is included in the Psychiatrists' Program policy. Could you please explain this coverage and why I need to have a policy that includes it?
A. An administrative action is a complaint filed by a patient with the psychiatrist's state licensure board or professional membership organization. Sometimes complaints are also filed with the psychiatrist's affiliated health care and managed care organizations. In an administrative action, a patient may allege that the psychiatrist is guilty of unprofessional conduct and should be sanctioned for that behavior.
It is not difficult for a patient to initiate an administrative action. Many organizations already have procedures for receiving and reviewing complaints.
Administrative actions are different from malpractice lawsuits because the patient does not have to prove negligence and damages. The psychiatrist may spend a lot of time and money until the patient's allegations are proved false.
The Psychiatrists' Program recognizes that malpractice suits are not the only reasons you need good insurance coverage. Administrative actions brought forth by state licensing boards, managed care organizations, hospitals, or health care organizations can financially impact your psychiatric practice. In addition, investigations by federal and state government agencies may also incur high and unexpected costs.
The Program has responded by providing coverage for these needs. The policy provides both administrative and governmental billing defense coverage with limits of $50,000/$100,000 at no additional cost.
Coverage includes legal expenses associated with preparing a legal defense for administrative, governmental-billing, and coding-error actions. Furthermore, if an action is brought forth, participants have access to a team of experienced defense attorneys who understand the intricacies of mental health practice.
For more information, contact Professional Risk Management Services Inc. (see contact information at end of article).
Q. My colleague attended a psychiatric-specific risk management seminar presented by Professional Risk Management Services in Orlando and found it quite helpful. Are there any other full-day seminars planned?
A. Yes. Professional Risk Management Services is presenting“ From Theory to Practice: Risk Management and Patient Safety” on September 30 in Columbus, Ohio. This seminar will address categories of clinical courses of action that can be taken with dangerous patients, steps that can reduce malpractice liability exposure associated with prescribing psychotropic medications, risk management strategies to reduce risk when treating patients with suicidal behaviors, as well as other topics that will help minimize professional liability risks.
Registration for this full-day seminar is $395, which includes the seminar materials, lunch, and refreshments during breaks. Discounts are available for early career psychiatrists and members-in-training. The seminar is free of charge for current Psychiatrists' Program participants, who are then also eligible to receive a 5 percent premium reduction on their Program insurance premium.
Those unable to attend this seminar may purchase the materials, resources, and handouts for $99. Participants in the Psychiatrists' Program unable to attend the seminar can purchase the materials for $35. To register, purchase the seminar materials, or view a full agenda, go to<www.prms.com> or call (800) 245-3333, ext. 347.
If you would like to receive e-mail updates regarding future seminars, please send an e-mail to [email protected].
This column is provided by PRMS, manager of the Psychiatrists' Program, for the benefit of members. More information about the Program is available by visiting its Web site at<www.psychprogram.com>; calling (800) 245-3333, ext. 389; or sending an e-mail to [email protected].

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Published online: 16 September 2005
Published in print: September 16, 2005

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