Professional Liability Insurance Headwinds and the New Normal in Teletherapy
The social worker profession is truly a noble one founded on service, integrity, and clinical expertise. At times, it can be a stressful and hazardous occupation. The nation is grateful for what you do, AND SO ARE WE! Thank you!
Here are the two key themes:
- The Professional Liability Insurance market is under stress; and
- Teletherapy will be a part of the new normal.
The key theme about the professional liability insurance market stress is reviewed as published in April 2021 by the insurance industry magazine Rough Notes, (p.-56), is that regarding professional liability insurance:
“A market already under stress faces the lingering impact of the pandemic”.
We’ll talk about the industry stress and the new normal. Even before the COVID-19 pandemic, the professional liability insurance market was hardening. Premiums were increasing from 25% for individuals to 150% for group malpractice coverage. Carriers face capacity limitations, occupational risk profile changes, and increased claims, which all drive premiums higher. According to James McNitt, area President for Risk Placement Services, many people view policies as unaffordable after several years of premium increases. (Rough Notes magazine, April 2021, p.-58).
Keep in mind that the NASW Risk Retention Group liability insurance products have never had a rate increase over 60 years and do not plan on any rate increases. Unlike competitors, they shall not reduce coverage and require deductibles.
Greg Leford, President of professional and executive liability insurance lines at The Hanover Insurance Company, noted two key observations:
- For the past 10 years, professional liability insurance premium “underpricing” (low rates in a soft market) was masked by favorable reserve releases, which are now exhausted. As a result, premiums are spiking combined with decreasing capacity as some carriers exit the product line; and
- Regarding actual practice treatment methodology, professionals of all sorts have had to practice social distancing, relying heavily on teletherapy and email. (Ibid) This is an indicator of the new normal, as mentioned further in this article.
Front line medical professionals were hit the hardest from COVID-19. There is still uncertainty of the pandemic’s impact on claims. The NASW Risk Retention Group has continued successful claims experience with low severity and lower than normal claims frequency. Two likely reasons support this:
- Client sessions are down because of COVID-19, so incident frequency and claims losses are down; and
- There has been an increase in teletherapy treatment.
Client sessions occurring in person will eventually return to normal. But in our opinion, a new normal is sprouting with greater use of teletherapy. Congress is considering legislation to loosen teletherapy restrictions and allow more use of teletherapy across state lines. From a micro viewpoint, the NASW Risk Retention Group has experienced significant volume increases in its HelpLine calls dealing with teletherapy questions and an increase in its cyber liability insurance policy sales, which protect against information breaches by third parties, which is excellent coverage to have when practicing in the teletherapy modality.
From a macro viewpoint, here is an overview of what the Federal Government is considering regarding teletherapy thus far:
- H.R. 4012 Expanding Access to Mental Health Services Act
Introduced June 17, 2021, which permanently broadens telehealth for Medicare members.
- H.R. 4040 Advancing Telehealth Beyond COVID-19 Act 2021
Re-introduced June 22, 2021, removes restrictions on smart devices and digital technology for therapy and permanently removes the originating site and geographic limitations.
- H.R. 4058/S.2061 Telemental Health Care Access Act of 2021
S.2061, introduced June 15, 2021, and H.R. 4058, introduced June 22, 2021, expands access to telemental health services by removing the statutory requirement that Medicare members be seen in person within six months of being treated for mental health services through telehealth.
- S. 2111 Audio-Only Telehealth for Emergencies Act
Introduced June 17, 2021, it allows physicians to deliver care during a public health emergency or a major disaster declaration to receive the same compensation for audio-only telehealth visits as they would receive for in-person appointments.
- S. 2097 Telehealth Health Savings Account (HSA Act)
Introduced June 17, 2021, it allows employers to offer high-deductible health plans that include telehealth services without limiting employees’ ability to use health savings accounts.
- S. 2110 Increasing Rural Telehealth Access Act of 2021
Introduced June 17, 2021, expands access to health care by improving remote patient monitoring technology for individuals in rural areas.
- S. 2197 Rural and Frontier Telehealth Expansion Act
Introduced June 23, 2021, amends Title XIX of the Social Security Act to increase the Federal medical assistance percentage for States that provide Medicaid coverage for telehealth services.
The profession is changing rapidly, with a new normal coming.
Thank you for all that you do as first responders and as behavioral health and social work providers. It is truly a noble profession needed now more than ever. Good luck and stay healthy!