Coronavirus (COVID-19) Information Center

The situation regarding COVID-19 is changing rapidly, and ProAssurance encourages insureds to stay current on all pronouncements from the CDC. For information and guidance, please review the CDC website, your state or local public health website, and your applicable board of medicine or dental board website. Check these sites frequently for updates and new developments.
 

COVID-19 Issues Affecting Our Customers

MEDICAL LIABILITY CONCERNS

 

PROASSURANCE SERVICE UPDATES

 

PROFESSIONAL LIABILITY COVERAGE ISSUES

ProAssurance cannot provide a coverage opinion or confirm coverage as to hypothetical claims. Coverage opinions are provided only after analyzing the specific allegations of an actual claim together with the applicable policy. The information here is general in nature and should not be interpreted to mean any given claim or actions by an insured will be covered by our policy. Rather, we will adhere strictly to the provisions of our policy, which is the only statement of our coverage obligations.

 

Telemedicine Coverage

Virtual visits and telehealth are covered under the ProAssurance policy within the scope of your practice and employment with the policyholder (likely your group or employer). 

If you wish to expand virtual visits and telehealth activities beyond your current employment, you may need additional coverage. Please contact your agent or service representative to confirm coverage when expanding virtual visits beyond your current practice situation. 

ProAssurance will waive the telehealth application and any additional premium associated with the telehealth exposure for up to four weeks, due to the pandemic. Insureds and agents are asked to notify the Company of each circumstance for file documentation. 

Since your policy may contain endorsements modifying the general rule, please review your specific policy to determine your coverage for telemedicine/virtual visits, and contact a service team member or your agent for specific policy questions regarding coverage. 

This item last updated 3/24/20.

 

Retired Physicians Returning to Practice

Physicians returning to practice from retirement on a temporary basis due to COVID-19 will not jeopardize the premium waiver reporting endorsement issued by ProAssurance.

For physicians seeking coverage for their return to practice activities, please contact your agent or ProAssurance service representative for assistance in submitting an application to the Company. We will endeavor to provide an underwriting decision for completed applications within two business days.

This item last updated 3/19/20.

 

Substitute Physicians (Locum Tenens)

Temporary substitutes for ProAssurance insured physicians are covered by the policy. You do not need to inform us of this arrangement as long as the length of their service is limited and within the scope of your typical medical practice. The language in your policy generally provides as follows:

The coverage provided to an insured professional or an insured paramedical employee will cover one or more qualified individuals who serve in the capacity of a temporary substitute in place of the insured professional or insured paramedical employee for not more than forty-five (45) days during the policy period; provided that any individual who serves in such capacity in place of multiple insured professionals or multiple insured paramedical employees shall be covered for no more than a total of ninety (90) days during the policy period. 

This item last updated 3/20/20.

 

Patient Exposure at Your Practice

Your professional liability policy may defend and indemnify you against claims by patients who allege they contracted the coronavirus at your office depending on the nature of the allegations. Negligent acts and omissions are generally covered, while liability for intentional conduct is excluded. For example, if a patient contracts the coronavirus at an insured’s office despite an insured’s best efforts to follow current guidelines, such a claim could fall within the coverage of the policy. Alternatively, if an insured continues to treat patients after the insured knows he or a staff member is contagious with the virus, this could lead to a claim of intentional conduct, which is excluded by the policy. 

This item last updated 3/23/20.

 

Office Staff Exposure at Your Practice

In general, our policies exclude coverage for any claim made by an employee, unless the claim arises from the employee’s status as a patient of the practice.  

This item last updated 3/23/20.

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PRACTICING TELEMEDICINE

Telemedicine Considerations

You can do virtual visits and telemedicine, but consider reimbursement options. Check with third party payors regarding reimbursement. With virtual visits, provide symptoms to consider and follow-up options, and document this communication. Consider privacy and security with any virtual or telemedicine options.

For more information regarding telemedicine, you can access videos and other educational information from ProAssurance by visiting ProAssurance.com/Telemed. Insureds can sign into our secure services portal to access an online seminar on telemedicine for CME here: https://secure.proassurance.com/seminars/education/online-seminars/.

Please visit the ATA website for more resources on telemedicine, including information and webinars regarding COVID-19: https://info.americantelemed.org/covid-19-news-resources.

This item last updated 3/19/20.

 

Patient Consent for Telehealth 

If you are practicing in a state where a patient must sign their consent for telehealth before continuing treatment, consider ways the patient can return a signed form such as via mail, email, or photograph. If these options are unavailable, consider allowing electronic signatures/initials/checking a box to confirm in writing that the patient consents to proceeding with a telehealth visit. Be sure to document in the record the consent discussion as well as any forms the patient signs or acknowledges.

This item last updated 3/19/20.

 

HIPAA Waiver

The Department of Health and Human Services (HHS) announced on March 17, 2020, a waiver of HIPAA penalties for good faith use of telemedicine. Read the HHS' Office for Civil Rights (OCR) Notification of Enforcement Discretion for telehealth remote communications during the COVID-19 nationwide public health emergency.

This item last updated 3/19/20.

 

Temporary Medicare Telemedicine Expansion

In order to protect senior citizens from the coronavirus outbreak, the HHS Office of Inspector General (OIG) has passed waiver 1135. As of March 6, 2020, Medicare will cover office, hospital, home, and other visits using telehealth on a temporary and emergency basis.

More information on the Centers for Medicare & Medicaid Services website.

 This item last updated 3/20/20.

 

Telepsychiatry Concerns

Privacy and security are important concerns to address. Consider discontinuing a virtual visit or telemedicine encounter if there are any problems with the connection. The American Psychiatry Association’s provides a toolkit for telepsychiatry: https://www.psychiatry.org/psychiatrists/practice/telepsychiatry/toolkit.

This item last updated 3/19/20.

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CDC, OSHA, & CMS RESOURCES

Information for Healthcare Providers from the Centers for Disease Control and Prevention (CDC)

Healthcare providers can find more specific information online regarding current interim guidance, resources for providers treating patients with coronavirus, how to manage persons under investigation (PUI), clinical care guidance, infection control, supply of personal protective equipment (PPE), and home care by visiting https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html.

This item last updated 3/19/20.

 

Office Warning Signs

The CDC made posters and signage available for download/printing; visit  https://www.cdc.gov/coronavirus/2019-ncov/communication/factsheets.html.

Consider alternate entrances for symptomatic patients and asking patients to wait in their vehicles until called by cell phone. Provide clear signage/directions at points of entry. 

This item last updated 3/19/20.

 

Preparing a Practice for COVID-19

Our advice is to plan for the worst scenario and work toward the best outcome. The full impact of the coronavirus on the US population is unknowable at this time. Assume for a moment that even if the clinical appearance of this virus in your patient population is low or even zero, your practice still may be affected.

Supplies necessary for your clinical practice may become scarce due to supply chain disruptions. Check nonperishable items and consider the levels you need to sustain patient care due to a supply interruption. Perishable items or those with extremely short shelf lives may be problematic as stock increases may not be prudent.

Also important are the office supplies needed to run your practice, even things as mundane as printer cartridges, for example. Take inventory of those items as well.

Consider the impact on your office or facility staffing in the event of daycare and school closings as well as ill staff members. Unfortunately, the majority of physicians do not have the capability and option of remote work as some businesses do.

The CDC provides Information for facilities/practices at https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/steps-to-prepare.html

This item last updated 3/19/20.

 

Care for Patients Suspected or Confirmed to Have COVID-19

Consider following the CDC Guidelines such as avoiding close contact with anyone who is suspected to or is confirmed to have COVID-19. Close contact is considered anything closer than 6 feet from a patient. Direct contact would be considered contact with infectious secretions such as sputum, serum, blood, and respiratory droplets. Try to triage patients who are suspect/confirmed cases by using infection prevention and control measures such as face masks and closing examination rooms to limit the spread in the office. Hand hygiene is also critical, so use alcohol-based rubs before and after contact with suspect/confirmed patients. Use soap and water if hands are visibly soiled. Also consider environmental cleaning and disinfecting throughout the office including waiting areas, patient care rooms, and bathroom facilities.

For more information, visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html.

This item last updated 3/19/20.

 

Protecting Staff from COVID-19 Exposure

The Occupational Safety and Health Administration (OSHA) is tasked with regulating employee safety. OSHA has compiled an extensive list of recommendations to protect workers from exposure, including establishing an emergency preparedness plan, providing certain physical safeguards, and encouraging administrative flexibility.

You can read all of OSHA’s recommendations at https://www.osha.gov/Publications/OSHA3990.pdf.

This item last updated 3/19/20.

 

Centers for Medicare and Medicaid Services (CMS) Updates

CMS is updating their website regularly with the latest information on the Coronavirus. The website includes information on the blanket waivers as well as more general information and press releases.  Visit https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page 

CMS has also created a General Provider Telehealth and Telemedicine Tool Kit. This document contains electronic links to reliable sources of information regarding telehealth and telemedicine. Most of the information is directed towards providers who may want to establish a permanent telemedicine program. However, there is also information that will be useful for providers who wish to care for patients through the virtual services that may be temporarily used during the COVID-19 situation. Download the CMS Tool Kit at https://www.cms.gov/files/document/general-telemedicine-toolkit.pdf.

This item last updated 3/26/20.

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CANCELLING/POSTPONING ELECTIVE PROCEDURES

Consider delaying elective surgery if the delay will not pose a risk to the patient. If a scheduled surgery is urgent but not emergent, surgeons should proceed at their discretion, taking into account infection risks to patients and staff as well as available physical resources. Even the unlikely event of an admission after outpatient surgery should be considered when allocating hospital resources. Consider making a joint decision with your patient where you explain the risks, benefits, and alternatives of the procedure and then document your thought process and ultimate decision.

We are monitoring state communications regularly. To view state-specific guidelines, visit the Coronavirus (COVID-19) Elective Procedures page.

Some states already have placed restrictions on elective surgeries, so it is advisable to verify any state-specific restrictions with the applicable public health authority in your state.

The American College of Surgeons has posted recommendations at https://www.facs.org/about-acs/covid-19/information-for-surgeons/elective-surgery. See also information provided by the CDC for postponing elective procedures in certain communities: https://www.cdc.gov/coronavirus/2019-ncov/community/index.html

This item last updated 3/19/20.

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MEDICAL OFFICE CLOSURES 

ProAssurance makes no recommendation on whether or when to close one’s practice or whether certain appointments should be canceled.

There is the possibility a patient may claim their medical condition worsened because the office was closed during efforts to contain the coronavirus outbreak. In general, your professional liability policy responds to claims for alleged injury arising from rendering or failure to render professional services.

As an employer there is no coverage under your professional liability policy for overhead expenses such as payroll if your office has to close (or chooses to close) due to coronavirus to cover overhead expenses.

 

U.S. Small Business Administration Loans

Physicians, dentists, and other healthcare providers unable to maintain their typical practice due to restrictions for managing the spread of COVID-19 may be eligible for a small business loan made available through the Small Business Association (SBA) and the federal CARES act. 

A variety of options are available to ease the financial hardship the pandemic has caused. For example, an Economic Injury Disaster Loan, which is available up to $2 million, can provide a loan advance of up to $10,000—helping to overcome the temporary loss of revenue caused by the COVID-19 pandemic. Advance funds will be made available within three days of a successful application, and the loan advance does not need to be repaid.

See resources available through the U.S. Small Business Administration.

This item last updated 4/1/20.

 

 

Recommendations for Dental Practices

DentistCare, the ProAssurance program focused on the unique needs of dentists and dental practices, maintains a comprehensive and regularly updated COVID-19 information center. There you can find recommendations and resources, including consent forms and patient sample letters available for download. The frequently asked questions section covers topics including: teledentistry, coverage & premiums, and practice management.

Visit the DentistCare COVID-19 Information Center.

This item last updated 4/2/20.

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Resources for Senior Care Insureds

Nursing Home Guidance Regarding Medical Supplies

CMS is aware certain areas are experiencing a scarcity of supplies (i.e. PPE including gowns, surgical masks, respirators, N-95 masks, etc.). State and federal surveyors have been instructed not to cite facilities for not having these materials if they are unable to source them. However, facilities should work to obtain the necessary supplies as soon as possible.

Facilities should also follow national or local guidelines for optimizing their current supply of PPE—including identifying the next best solution to care for residents. This may mean prioritizing access to supplies based on the risk of exposure or extending the use of PPE.

For the latest guidelines:

PHE preparedness planning
CDC guidance on coronavirus for healthcare professionals
CDC guidance on coronavirus for healthcare facilities
CDC strategy for PPE allocation

This item last updated 4/2/20.

 

Waivers for Surge Capacity

This week, the federal government released several new waivers directed at helping stop the spread of novel coronavirus (COVID-19). These include specific guidance that allows transfer of patients who have tested positive for the disease as well as relaxing requirements to establish new care sites to address “surge capacity.” This may include opening new facilities or setting up non-resident rooms as temporary care areas.

The waivers also temporarily wave some training and certification requirements for nurse aids to address workforce strain.

Full CMS release

This item last updated 4/2/20.

 

CMS Self-Assessment for Facilities

The Centers for Medicare & Medicaid Services (CMS) updated its national strategy for protecting patients during the COVID-19 pandemic—including a new, COVID-19 focused inspection process. The inspection includes a self-assessment tool for providers to complete.

The CDC encourages facilities to use the tool to assess their ability to prevent spreading COVID-19 and is encouraging residents and families to ask how the facility performed on the assessment. This is part of their larger strategy to be proactive in protecting nursing home residents during the pandemic.

Get the new self-assessment here

This item last updated 4/2/20.

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RISK MANAGEMENT SEMINARS & EVENTS

Public Loss Prevention Seminars Cancelled through May 15, 2020

Physician and practice administration professional public seminars are cancelled through May 15. This affects seminars in Alabama, Delaware, District of Columbia, Florida, Illinois, Indiana, Maryland, Missouri, Nevada, and Ohio. We will continue to monitor the situation and update this page.

For a list of currently available seminars visit ProAssurance.com/Hindsight (physician program) and ProAssurance.com/AnOunce (practice administrator program).  

This item last updated 3/30/20.

 

Registration Fees for Cancelled Public Seminars

As we expect to present seminars scheduled for later in the year, customers with prepaid registrations can apply them to a future session. To reschedule or request a refund, please contact Risk Resource at RiskAdvisor@ProAssurance.com or 844-223-9648, option 2.

This item last updated 3/30/20.

 

Eligibility to Earn Premium Credit Due to Seminar Cancellation

Insured physicians who registered for a seminar cancelled due to COVID-19 and who are eligible to receive a premium credit for attendance may take Hindsight 2020 online for the same amount of premium credit. 

This item last updated 3/30/20.

 

Hindsight 2020 Online Seminar Version Now Available for Potential Premium Credit

The online version of Hindsight 2020 is now available. Insureds can access this and other online seminars by signing in to ProAssurance.com, then choosing "Seminars" and "Physician Online Seminars." Insured physicians may be eligible for premium credit at renewal, depending on the program by which they are insured and the state in which they practice.

This item last updated 3/30/20.

 

Premium Credit Questions

We understand there are questions related to course completions and policy renewal date timing. These will be evaluated on a case-by-case basis. If your situation needs special attention, please contact your agent or call your ProAssurance underwriter at 800-282-6242.

This item last updated 3/30/20.

 

On-Site Risk Assessments Cancelled

On-site risk assessments and any associated staff education seminars are cancelled through May 31, 2020, and through June 30, 2020 for Senior Care facilities.

This item last updated 3/18/20.

 

Risk Resource Presentations and All Other Events Cancelled 

Presentations at association and other group meetings are cancelled through April 30, 2020. Check with the meeting organizer for event status.

For the status of any other currently scheduled meeting involving ProAssurance Risk Resource staff, please ask your agent or the group's contact.

This item last updated 3/18/20.

 

Risk Management Newsletters Available Online Only

To narrow the scope of communications to our insureds during this challenging time, we’re not sending out email or other communications with risk management newsletter content. However, we’ll continue to post new editions to keep you informed at ProAssurance.com/Newsletters. The following newsletters are available to the public:

Insureds also have access to Vital Signs: Case Studies of Medical Liability Suits, by Specialty in the Secure Services Portal.

This item last updated 3/20/20.

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PREMIUM PAYMENTS

ProAssurance will suspend cancellations due to non-payment of premium for active policies until June 30, 2020 for invoices due after April 1, 2020. Additionally, we will remain in compliance with the Departments of Insurance (DOI) for individual states which have guidance beginning before or ending after our own grace period. NOTE: Invoice mailing/automated payment plan debits already established will proceed as normal unless there is specific direction from your state’s DOI; this is simply a notice your policy will not be canceled due to non-payment during the grace period.

We recognize the potential for financial hardship on medical practices during this crisis. ProAssurance will continue to monitor the situation and be ready to review this and all other accommodations accordingly. For a current list of relevant bulletins, please visit our COVID-19 Department of Insurance Bulletins page.

If you have a situation that merits special consideration beyond what is stated here, please let us know by completing a Premium Payment Deferral Request Form.

This item last updated 3/25/20.

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PENDING CLAIMS AND LAWSUITS

If you have any questions about a pending claim or lawsuit, please call your defense counsel or your ProAssurance claims representative. Your defense counsel and claims representative are working and can be reached at the numbers previously provided to you. Your defense attorney and claims representative are able to assist you with many questions you may have related to the status of your file, including whether your scheduled deposition, hearing, or trial may be postponed. Additionally, if you need to reschedule any pending meeting, hearing, or trial due to your current workload, your own illness, or for any other reason, please contact your defense counsel or claims representative.  

ProAssurance currently does not anticipate any interruption in our services. Every claims person has and will continue to have the ability to work remotely with full computer, phone, and support services. Regular mail processing will continue. You will be able to contact us through all means with the exception of in person meetings, and we will stay in contact with you. We have made preparations for staff to be fully functional during this timeframe. In short, other than person-to-person contact, you should experience no difference in our availability and service during this period. 

This section last updated 3/22/20.

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ONLINE SELF-SERVICE OPTIONS

Many Self-Service Options Available Online

In the event of a ProAssurance service disruption due to impacts of the pandemic on staff, be aware numerous online self-service options are available to healthcare professional liability insureds, policyholders, and agents­. These include online seminars, credentialing certificates, bill payment, policy documents, billing account summaries, and more.

The available services are outlined by audience on our secure services portal page.

 

How to Create an Account

Select the “Create an Account” button in the top banner of this website. Fill in your name and information. If you need assistance, contact Web Support at 205-439-7956 or WebSupport@ProAssurance.com.

 

Online Premium Payments

You can make individual payments online or enroll in the Electronic Payment Plan (EPP) to have future payments automatically debited through a checking or savings account. Please note: ProAssurance doesn’t accept credit cards. Enroll in EPP online or make a payment in the secure services portal.

 

Certificates of Insurance (COI)

Inside the secure services portal, select the Certificates of Insurance and Claims History page from the “Credentialing” menu. Follow the instructions to download a COI. If you are not authorized to view a COI, you may need to request to Add a COI Holder. For questions or additional assistance, please contact the Credentialing department at 877-274-7007 or Credentialing@ProAssurance.com.

 

Continuing Medical Education (CME) Credits

We currently offer almost 20 hours of CME from a variety of courses. Access Physician Online Seminars  in the "Seminars" section of the secure services portal. Most are eligible for premium credit.

 

ProVisions agent newsletter emails will continue

We’re still planning to send out the ProVisions monthly agent newsletter as expected. Our archive is available in the Secure Services Portal for ProAssurance-appointed agents under the “Agent” dropdown menu, ProVisions Newsletter.

 

Web Support Contact Information

Contact Web Support at 205-439-7956 or WebSupport@ProAssurance.com.

This section last updated 3/17/20.

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PROASSURANCE WORKFORCE CONTINUITY

Regular Business Hours

ProAssurance remains open 8:00 a.m. - 5:00 p.m. local time. Most employees are working remotely, but can still be reached in a timely manner. We appreciate your patience and understanding during this time. We are actively monitoring the volume of work and workflows in this fluid situation. We appreciate your patience as we work to serve your needs. 

 

Safeguarding Employees

ProAssurance is proactively working to ensure its employees and business partners are protected. By significantly reducing the number of employees in each office, we can help reduce the risk of exposure and the potential of having an employee come in contact with the virus while at work. The majority of our employees have already transitioned to home/remote work. 

This section last updated 3/19/20.

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FEEDBACK ON THIS PAGE

Didn't find the COVID-19 information you were seeking on this page? 
Let us know what we missed or need to clarify.

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Dept. of Insurance Bulletins

We're monitoring state Departments of Insurance for directives regarding premium payment, cancellations or nonrenewal notice grace periods, and other bulletins or recommendations.

Visit the COVID-19 Dept. of Insurance Bulletins page.

This section last updated 3/31/20.

 

Dept. of Health Orders

We're monitoring Departments of Health for orders to postpone elective surgical procedures. 

Visit the COVID-19 Dept. of Health orders page.

This section last updated 3/31/20.

 

Contact Us

Call ProAssurance toll-free 800-282-6242.

Contact our Risk Resource Advisor line: 844-223-9648 and select option 1, or email RiskAdvisor@ProAssurance.com.

To report a claim, call Claims: 877-778-2524 or email ClaimsIntake@ProAssurance.com.

Didn't find the COVID-19 information you were seeking on this page? Let us know what we missed or need to clarify.

 

Online Services

For a list of online services, visit the secure services portal (SSP) page

Sign into the SSP from the top banner on any ProAssurance.com page.

To create an account, add your information here to access these services for insureds and agents. 

 

ProAssurance Alerts

4/3/2020 - New Online Seminar "Hindsight 2020"

3/20/2020 - COVID-19 Information Center and Online Services

3/16/2020 - Public Loss Prevention Seminars Cancelled Through April 30

3/13/2020 - COVID-19 Memo From ProAssurance Chief Medical Officer

3/11/2020 - Senior Care COVID-19 Resources

This section last updated 4/3/20.

 

COVID-19 Communications from Other ProAssurance Companies