Today in Florida, one in six physicians will suffer a malpractice or licensure complaint during their career. Typically half the cost will be spent on legal defense.
Meeting changing client needs in today’s uncertain healthcare climate, Florida Health Professionals Legal Expense Insurance Inc. (FHPLEI) is one of only a few firms in the state that offers licensed healthcare professionals both malpractice and licensure legal expense insurance.
“While we are not a risk retention or a medical malpractice carrier, we are a much more value-sensitive carrier, offering coverage for the first dollar spent on legal defense,” said Rusty Huseman, General Counsel for FHPLEI. “Our firm is for doctors and about doctors – that is our worth.”Founded in 2002, the privately held Jacksonville firm offers coverage limits up to $50,000 for legal-related expenses for licensure investigations and defense, Medicare or Medicaid post-payment audits and civil investigations, HIPPA investigations and OSHA citations. FHPLEI’s second product provides coverage to group practices and individuals for legal-related fees and expenses for medical malpractice.
The firm’s clients are healthcare professionals who are either augmenting their coverage for the first dollar of legal expense, or who are operating without insurance, known as “going bare.”
“We want our doctors to have autonomy in malpractice complaints,” said Huseman. “In Florida, insurance carriers can decide to settle a case without a doctor’s involvement, regardless of whether or not wrong was done. Our firm differs from that – we have a panel of attorneys who can offer advice with attorney-client privilege, yet give the doctor the option of moving forward in malpractice complaints.”
The Patient Protection and Affordable Care Act (PPACA), healthcare reform signed into law by President Barack Obama last year, has caused unrest among healthcare professionals, Huseman noted. “Many senior doctors are retiring because they are worried about the uncertainties of the new healthcare climate,” he said.
FHPLEI is adapting by looking at every facet of healthcare today, evaluating and proactively addressing the needs of its clients. “As a private company, we are more entrepreneurial and able to react quickly to add different types of coverage as needed,” said Huseman.
For example, the firm is expanding its broad-form legal defense product offerings to include two forms of new Medicare audits – the Recovery Audit Contractor (RAC) audit and Zone Integrity Program Contractor (ZIPC) audit.
RAC audits are part of the efforts of the Centers for Medicare & Medicaid Services (CMS) to mitigate overpayments to providers. ZIPC audits are a new CMS initiative to reduce Medicare fraud through surprise on-site visits, targeted analysis and follow-up to whistleblower actions.
If a client receives a ZIPC audit, a panel of FHPLEI attorneys will use an independent auditor to determine if irregularities occurred, and provide coverage for the legal expense to make sure what the doctor billed is correct. If there are irregularities, the lawyers will help the doctor with reporting and cover the legal expense through the limits of the policy.
“FHPLEI is about empowering physicians to make smart choices in their practice,” said Huseman. “We offer them a place to go to get answers, and have knowledgeable, professional attorneys in licensure law, malpractice events and administrative law to help do preliminary risk assessments before a problem arises.”
Currently, the firm markets its services through its website, direct mail marketing, trade shows, and word of mouth from existing clients. It will soon introduce a new blog on its website to provide a forum for questions and answers.
