Although probably the most frequently mentioned, malpractice actions are not the only risks for Occupational Therapy (OT) practitioners to consider. There’s been an increase in the number of adverse actions taken against OTs by licensing boards and practicing outside scope of license is also common. Not properly addressing all risks can leave OTs open to financial hardships and steal focus from patient care.
From the period of 1998 to 2014 (last reporting report) there were 1,355 NPDB adverse action reports. Reportable adverse actions include, among others those taken by state licensing boards, health plans, governmental agencies, and professional societies. Almost 90% of the adverse actions against an OT involved a state licensure board action. There were 19 exclusion and debarment actions reported to the NPDB.
The defense of a licensing board complaint can be costly. If the state licensing board investigation is related to acts while employed by an organization, typically the organization will assist in the legal defense and bear the associated costs. The organizational insurance policy may exclude any fines and penalties that results from the investigation.
If the act(s) under investigation arise from a self-employment practice, the professional liability policy may respond to cover the legal defense cost. If you practice as an independent contractor and purchase your own professional liability coverage, you should inquire whether the policy covers professional licensing matters. Many policies will cover defense costs, but will not respond if fines and penalties are assessed as a result of a violation of your practice act.
Some examples of adverse actions include:
- Unprofessional conduct (violating the code of AOTA code of ethics)
- Practicing outside the scope of practice
- Providing substandard care to a deliberate or negligent act or failure to act
- Knowingly delegating responsibilities to an individual who does not have the knowledge, skills or abilities to perform those responsibilities
- Failing to provide appropriate supervision to an Occupational Therapy Assistant or Aide
- Engaging in or soliciting sexual relationships, whether consensual or non-consensual, while an OT or OTA /patient relationship exists.
Another common allegation is practicing outside of the scope of your license. The scope of practice describes the actions that a healthcare practitioner is allowed to undertake based on their professional licensure. A scope is typically statutorily defined by a state practice act, regulations set forth by a professional licensing board, or state and federal organizations such as those set forth by the Centers for Medicare and Medicaid Services.
Practicing outside of your legal scope of practice is a violation of your practice act and may place you at risk for an adverse action with your professional licensure board. As the scope of practice for OT practitioners continues to evolve, it’s important to understand and practice within the boundaries of your scope of practice. The AOTA provides some scope of practice guidance on issues such as use of cold laser, treatment of spine and LE injuries, and gait assessment for falls risks among others.
The Ethics Commission of the AOTA reviews and investigates ethics complaints filed against AOTA members. Disciplinary actions that may be recommended by the Ethics Committee include reprimand, censure, probation, suspension, and revocation. The Commission maintains an online listing of disciplinary actions taken. It’s important to periodically review the AOTA’s Code of Ethics and keep abreast of professional standards and practice guidelines to avoid being in the “line of fire” for a licensure board action or a violation of AOTA’s ethics code.
By identifying and assessing risks, OTs can ensure they are avoiding malpractice, adverse actions, and practicing outside of their scope of licensure. OTs place patients at the center of their attention and OmniSure is here to help make providing quality care easier. Contact us today to learn how you can benefit from our expertise.