No Change in Services

Q. Do I still have access to the Risk Management Consultation Service now that the Psychiatrists’ Program has new insurance carriers?

A. Yes, the toll-free Risk Management Consultation Service (RMCS) remains a value-added benefit. Current program participants will continue to be able to call the helpline and speak personally with risk managers, who provide advice tailored to participants’ individual needs and situations. Issues addressed frequently include ending a professional relationship with a difficult patient, responding to a subpoena or a request for information, the informed-consent process, shared liability in collaborative treatment arrangements, implications of HIPAA’s privacy rule, and dealing with the aftermath of a patient suicide. The RMCS is available by phone at (800) 527-9181 or the program’s Web site at www.apa-plip.com from 8:30 a.m. to 5:30 p.m. Eastern time.

Other services available on the program’s Web site include a comprehensive library of risk management articles and information, practical pointers, HIPAA information, the Rx for Risk archive, the Online Education Center, and links to other mental health, practice management, and insurance resources.

Q. In a previous column, you discussed “hammer clause.” I am purchasing insurance and noticed that the policies I reviewed do not use that particular term. Would you explain again the concept of “hammer clause”?

A. The term “hammer clause” is insurance-speak for a particular type of “consent to settlement clause” in a professional liability insurance policy. As you noted, the term “hammer clause” does not appear in a policy. If the policy does have a “hammer clause,” however, you might find language such as “if the insured withholds consent to a settlement that the insurance company has deemed proper, the insurance company’s duty to defend the insured will end. From that point on, the insured will incur defense expenses and incur liability for any judgment or settlement in excess of the proposed settlement.”

In other words, the hammer clause allows the insured to reject an offered settlement, but the insured assumes personal liability for the amounts greater than the rejected settlement amount. The insurance company’s liability of judgment or settlement will not be for more than the amount it would have paid had the insured consented. The difference between the two can be very sizeable—a heavy hammer.

You should be aware that at least one of the national insurance companies writing policies for psychiatrists in today’s market has this “hammer clause” in its policy. Call the program at (800) 245-3333, ext. 389, for more information and a quick policy comparison.

Q. I read about the HIPAA privacy rule in a previous column. Haven’t there already been changes to the final privacy rule?

A. No. In May the Department of Health and Human Services proposed modifications to the final privacy rule, but the proposed changes have not been finalized. Any modifications should be finalized by October. Additional information on the proposed changes can be found in the “HIPAA Help” section on the program’s Web site at www.apa-plip.com.

Q. Is it true that I can get an extension for compliance with the HIPAA privacy rule?

A. No. There is no extension available for the privacy rule—covered providers must be in compliance by April 14, 2003. Under the transactions rule, a one-year extension for compliance is available. The extension must be obtained prior to October 15, 2002; otherwise, compliance will be required as of October 16, 2002. For more information on the transactions rule extension, please visit the program’s Web site at www.apa-plip.com in the “HIPAA Help” section.

Q. Where can I get more information and updates on the HIPAA privacy rule?

A. There are several resources available from the Psychiatrists’ Program for APA members to learn more about HIPAA and specifically how the privacy rule affects psychiatrists. The program’s Web site at www.apa-plip.com features HIPAA facts and figures, diagrams, advisories, updates, related resources, and more.

Q. What resources about HIPAA are available to program participants?

A. The program has recently developed a HIPAA resource manual available only to program participants, which includes model forms. In a few weeks the full text of the manual will be available online in the program’s “For Participant’s Only” section at www.apa-plip.com. In the meantime, program participants can call (800) 245-3333, ext. 347, to order their copy for $5 to cover shipping and handling.

The “For Participant’s Only” section also features three online HIPAA presentations, including “An Overview of HIPAA’s Privacy Rule,” a 36-minute presentation including handouts. ▪

This column is provided as a service to the membership by the Psychiatrists’ Program, the APA-endorsed Psychiatrists’ Professional Liability Insurance Program. Send your questions to [email protected].