Why FTCA Protection Matters

For Federally Qualified Health Centers (FQHCs), malpractice coverage under the Federal Tort Claims Act (FTCA) is essential. It shields organizations from the high costs of liability claims—but comes with strict requirements.

Chief among these requirements is the need to maintain a robust quality assurance and peer review program. And not just on paper—your systems must produce documented evidence that you actively review and improve clinical quality.

FTCA Requires Proactive Peer Review

HRSA makes it clear: FTCA coverage is contingent on a functioning peer review system that can:

• Evaluate providers regularly
• Identify and act on quality or safety concerns
• Document actions taken to prevent recurrence

It’s not enough to say you have a peer review program—you need clear records to back it up. When a malpractice claim surfaces, these records are one of your first lines of defense.

How External Peer Review Strengthens Your Case

External peer review doesn’t just check the box—it raises the standard of defensibility and objectivity. Here’s how:

✅ Objective Third-Party Validation

Unlike internal reviews, external reviews are conducted by independent professionals with no ties to your staff. This makes the feedback more credible in the eyes of regulators, plaintiffs, and HRSA reviewers.

If your internal team said the care met standards, a plaintiff attorney might argue bias. But when a qualified external physician—especially one in the same specialty—says the same, that opinion carries far more legal weight.

✅ Subspecialty and License-Level Accuracy

One key FTCA compliance issue is ensuring that peer reviewers are appropriately licensed and qualified. It’s not sufficient for a generalist to review a subspecialist’s work.

External review platforms like Medplace allow you to match providers with reviewers in the correct specialty and license level—ensuring FTCA standards are met and defensibility is maximized.

✅ Timely and Complete Documentation

FTCA requires evidence that reviews are happening regularly—typically quarterly—and are being followed up when concerns are raised.

External reviewers meet deadlines. There’s no chasing, no lost forms, and no half-completed reviews. Every review includes:

• A complete record of the charts reviewed
• Structured questions and scores
• Comments for deficiencies
• Recommendations for remediation
• Evidence of follow-up (when applicable)

All of which can be instantly retrieved during a site visit or legal discovery.

A Real Deterrent to Malpractice Claims

It’s not just about documentation—it’s about prevention.

When your providers know that external experts are regularly reviewing cases and identifying risks before an adverse outcome, you reduce the likelihood of a claim ever being filed. And when something does happen, you have credible evidence of due diligence and continuous quality assurance.

Protect Your Patients and Your Coverage

FTCA protection is a privilege, not a guarantee. To keep it, you need a strong peer review program—and external review is your strongest asset.

It reduces bias, strengthens documentation, ensures compliance, and improves outcomes. In an age of increasing scrutiny and liability risk, external review is no longer a luxury. It’s a necessity.

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