On January 7, 2025, the Health Resources and Services Administration (HRSA) published Program Assistance Letter (PAL) 2025-01, Calendar Year 2026 Requirements for Federal Tort Claims Act (FTCA) Coverage for Health Centers and Their Covered Individuals. The PAL describes the deeming requirements for health centers for CY 2026 and sets a deadline of June 27, 2025, for submission of redeeming applications. "Eligible entities that do not submit a redeeming application by the deadline may experience a gap in FTCA coverage and should consider purchasing private malpractice liability insurance for CY 2026" (PAL 2025-01). New applicants may submit an initial deeming application at any time the Electronic Handbook (EHB) is open to accept applications. HRSA will communicate dates when the EHB is closed for maintenance. New applicants who wish to be deemed for CY 2026 should submit applications early enough (we recommend no later than October 1) to allow HRSA to complete their review.
The deeming application for CY2026 itself is identical to last year's (CY2025) application. We note that last year's deeming application (CY 2025) instituted a number of key changes that continue this year and are summarized below:
- Required FTCA trainings in areas of Obstetrics, Infection Control, HIPAA, and Areas of Risk are separated into four individual questions.
- Applicants are required to enter their training tracking information in the "FTCA Educational Training Tracking Form".
- Uploading of quarterly assessments is divided into four questions or sections (4(A) – 4(D)).
- The Credentialing and privileging process now includes a reference to the newest policy on temporary privileges, PIN 2024-01 Temporary Privileging of Clinical Providers by Deemed Public Health Service Employee Health Centers Impacted by Certain Declared Emergencies or Other Emergency Situations. Be aware that these are the only circumstances where temporary privileges may be used.
- Credentialing and Privileging must be completed at least every two years.
- The claims management section included a new attestation related to provision of documents for the Department of Health and Human Services, Office of the General Counsel, General Law Division.
HRSA is required by law to make a determination on the deeming application within 30 days after receipt. Deeming applications will initially be reviewed for completeness. If additional information or clarification is needed, you will be notified by HRSA and you will have 10 business days to supply the requested information. If the review of the application results in a determination that the health center has not demonstrated that it meets the requirements and is in danger of being disapproved, HRSA will notify the health center via a "compliance notice" outlining the deficiencies and give the health center 30 days in which to respond. However, for CY2026 HRSA has added a new limitation on the use of compliance notices. Health centers that receive an FTCA Site Visit as part of their application review will, under certain circumstances, not be afforded a "Compliance Notice" prior to disapproval.
Final decisions on deeming applications will be transmitted through the EHB.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
