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Administrative and Judicial FTCA Claims Process

Tort claim presented to appropriate Federal agency within 2 years after claim arises (28 U.S.C. §2401(b))

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No duplication of insurance coverage: U.S.pays

Duplication of coverage and insurance company refuses
to pay: U.S. pays and files suit for indemnification and/
or subrogation

Duplicative coverage and insurance company accepts its payment responsibility: company pays up to

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Attachment 10

The Experience of Community and Migrant Health Centers

under the Federal Tort Claims Act (FTCA)

The experience of community and migrant health centers is similar to the experience of tribes and tribal organizations under the FTCA. Federally-supported community and migrant health centers and their clinical personnel have been covered under the FTCA for malpractice claims filed against them since January 1, 1993. In extending FTCA coverage to the health centers, the Congress intended to allow the centers to continue meeting the pressing health care needs of their patients and communities while significantly reducing the centers' need for, and the costs of, privately-purchased malpractice coverage. However, coverage was extended for an initial period of only three years, and its scope excluded some important health center activities and personnel, making it necessary for most covered health centers to continue purchasing at least some level of private malpractice insurance, while some were forced to severely restrict or eliminate vital services. Some of these problems and coverage gaps were addressed in later legislation amending and extending this FTCA coverage.

Background and History

The federal community and migrant health center programs were established more than 30 years ago to provide grant support to local public and private nonprofit organizations for the development and operation of service delivery sites that furnish health care services to residents of medically underserved communities. In 1995, some 722 federally-supported health center

organizations operated more than 2200 local health center service sites providing health care to

Center for Health Policy Research

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