Federally qualified health centers, rurally important, are insulated from lawsuits; here's a list of what taxpayers paid

Screenshot of top of KHN list, adapted by The Rural Blog; the whole list, which is searchable by state, is here.

Federally qualified health centers, or FQHCs, are very important parts of the health-care delivery system for the poor in rural areas. They must not turn anyone away, and charge patients based on their income. In return, they get an annual grant and higher reimbursements from Medicaid and Medicare — and, for the vast majority of clinics, financial immunity from malpractice lawsuits.

The centers can still be sued for malpractice, but the federal government pays the settlements or judgments. That little-known aspect of FQHCs is examined in a story by Phil Galweitz and Bram Sable-Smith of Kaiser Health News, along with a list of the 485 payouts made on the centers' behalf from 2018 through 2021, totaling $410 million. "Nearly half of the centers’ patients are covered by Medicaid, and 20 percent are uninsured," Galewitz and Sable-Smith report.

To win congressional protection in the 1990s, the clinics "argued their revenues were limited and malpractice insurance would divert money that could better be used for patient care," KHN reports. About 86% of the 1,375 clinics have protection; to get it, a clinic "must have quality- improvement and risk-management programs and must show regulators that they’ve reviewed the professional credentials, malpractice claims, and license status of their physicians and other clinicians. . . . Ben Money, a senior vice president for the National Association of Community Health Centers, said the process improves care and directs scarce operating dollars toward the needs of patients, versus costly malpractice coverage." Attorney fees are limited to 25 percent of awards.

"A patient alleging medical malpractice by a health center must first submit claims to the U.S. Department of Health and Human Services for review. The government can make a settlement offer or deny the claim. If the claim is denied or not settled, or a six-month review period expires, the patient may sue in federal court under the Federal Tort Claims Act," KHN reports.

"Malpractice lawsuits are a risk for all health-care providers and are just one barometer of quality of care. The settlements and court judgments against the health centers don’t measure the clinics’ overall performance. Even lawyers who have sued on behalf of health center patients acknowledge the importance of the facilities. Rhode Island plaintiff attorney Amato DeLuca said that the health centers serve a vital role in the health industry and that he had found “a lot of really wonderful, extraordinarily capable people that do a really good job” at the centers. Yet everyone must be held accountable for mistakes, DeLuca said."