Texas Medical Liability Trust PROUDLY the SERVING Texas physicians and policyholders REPORTER since 1979 with quality coverage and 2015 Volume 4 responsible pricing. IN THIS ISSUE: TMLT launches Lone TMLT launches 1 Lone Star Alliance, Inc., Star Alliance, Inc., RRG to cover out-of-state physicians RRG to cover out-of- CME Activity: state physicians 4 Following TMB guidelines when providing pain management MLT proudly care announces the launch of Lone Star Alliance, Inc., RRG. 14 Risk T management Lone Star Alliance, a risk services: retention group operated by outcomes TMLT, was established to and trends provide medical liability and similar types of insurance to physicians, groups, health Closed Claim 18 care facilities, and allied Study 1: health care professionals Alleged outside of Texas. unnecessary surgery Lone Star can accommodate the needs of TMLT’s new and existing policyholders by 20 Closed Claim writing insurance for those Study 2: who have operations in states Failure to other than Texas. Lone Star follow up can also cover policyholders who leave Texas to work in another state. (Continued on page 2) TMLT the Reporter As sponsor and program manager for Lone Star, handling, and risk management functions. TMLT provides all essential operational These services are provided under a support to the RRG, such as financial and management services agreement. accounting services, information technology, underwriting, sales, marketing, claims Where is Lone Star Alliance located? handling, and risk management functions. Lone Star is domiciled in Washington, DC, These services are provided under a but our office is located in Austin, Texas. management services agreement. What kind of policies does Lone Star offer? Lone Star was started in 2013 when TMLT Lone Star offers a full range of medical began exploring how to extend coverage to liability coverage options for individual policyholders who were also practicing in other and physician groups, and allied health states. Lone Star Alliance is domiciled in care professionals. We offer claims-made Washington, DC, but it shares offices with (including prior acts or “nose coverage”) and TMLT in Austin. occurrence policies at a variety of limits. Per-patient rated policies and shared-limit “With Lone Star, we are no longer bound by policies are also available. Policies include state lines. More importantly, neither are our cyber liability protection, regulatory actions physicians,” says Robert Donohoe, President protection, medical director coverage, and and CEO of TMLT. “We can now serve employment practices liability insurance. physicians anywhere in the United States with View policy options at www.lonestara.com/ the same strong, flexible coverage and winning policy-detail.html. defense strategies Texas physicians receive from TMLT.” Who can apply for coverage? Any physician, group practice, allied health FREQUENTLY ASKED QUESTIONS (FAQ) care professional, or health care entity located What is Lone Star Alliance, Inc., RRG? outside of Texas can apply for coverage with Lone Star Alliance is a risk retention group Lone Star. “With Lone operated by TMLT. It was established to provide medical liability and similar types of If a practice located in multiple states Star, we are no insurance to physicians, groups, health care applies for coverage, the Texas-based longer bound facilities, and health care professionals in physicians may be insured through TMLT and multiple states. Lone Star can meet the needs the physicians based outside of Texas will be by state lines.” of TMLT’s new and existing policyholders insured through Lone Star. by writing insurance for those who have operations in states other than Texas. How do I obtain a quote? Please contact your agent or a Lone Star What is a risk retention group (RRG)? representative at [email protected] or call An RRG is an alternative insurance entity 512-425-5890. created by the federal Liability Risk Retention Act (LRRA). RRGs must form as liability How do I apply for coverage? insurance companies under the laws of at least Please contact your agent or a Lone Star one state—its charter state or domicile. The representative at [email protected] or call policyholders of the RRG are also its owners. 512-425-5890. Membership must be limited to organizations or persons engaged in similar businesses or Do I have to become a member of the Texas activities, thus being exposed to the same Medical Association (TMA) to purchase types of liability. coverage with Lone Star? No. TMA membership does not apply to Does TMLT own Lone Star Alliance, RRG? Lone Star Alliance. TMA membership remains No. TMLT and its subsidiaries—as a requirement for coverage with TMLT. sponsor and program manager for Lone Star —provide all essential operational support How do I continue coverage if I decide to to the RRG. Support includes financial and leave Texas? Do I have to re-apply for accounting services, information technology, coverage in Lone Star? underwriting, sales, marketing, claims Because we will need information about 2 TMLT the Reporter your new practice, we will ask you to complete Can I take a TMLT CME course and a short application. Please contact your receive a discount for Lone Star? underwriter at 800-580-8658. No. You must take a Lone Star CME course to earn the discount. Courses are available on What is the difference between Lone Star the Lone Star CME site at lonestara.inreachce. coverage and TMLT coverage? com. The Lone Star policy mirrors the TMLT policy with the exception of state-specific Can I apply my TMLT practice review requirements. Lone Star policies are flexible discount to my Lone Star policy? and specific policy needs can be modified or No. Your TMLT practice review discount endorsed. will not apply to your Lone Star policy. Do I qualify for Trust Rewards in Lone Does the Lone Star claims philosophy Star? align with TMLT’s claims philosophy? TMLT Trust Rewards cannot be extended Yes. Each claim is aggressively defended to Lone Star Alliance policyholders. and we do not settle non-meritorious lawsuits. If a case requires a compromise settlement, What happens to my Trust Rewards our experienced claims staff negotiates to balance if I move to Lone Star? obtain the best possible result. Additionally, Because Lone Star policyholders are not TMLT/Lone Star only hires experienced, eligible for the TMLT Trust Rewards program, specialized, medical malpractice defense you will not receive additional Trust Rewards attorneys to represent our policyholders. allocations while you are insured with Lone Star. However, your existing Trust Rewards Can a Lone Star claim be settled without balance will remain intact while you are with my consent? Lone Star and you will be eligible for payout No. Cases are not settled without a distributions pursuant to qualifying events. policyholder’s consent. Will I receive a dividend through Lone To learn more about TMLT and Lone Star, Star? please visit www.tmlt.org/lonestar. Lone Star does not have a dividend program at this time. What discounts are available through Lone Star? Lone Star rewards physicians for their patient safety efforts. The following premium discount opportunities are available in most states: • discounts for favorable claim experience; • group purchasing credits; • discounts for new-to-practice physicians; • part-time discounts; and • discounts for completing a risk management CME course (up to 5 percent for two courses; courses must be 2.5 hours in length to qualify). Does Lone Star offer CME? Through our Risk Management Department, Lone Star offers home-study programs and online courses to help reduce liability risk. Courses are available on the Lone Star CME site at lonestara.inreachce.com. 2015 VOLUME 4 3 OBJECTIVES | At the conclusion of this educational activity, the physician should be able to: 1. discuss the rules and mandates by which physicians are evaluated by the TMB during an Informal CME Settlement Conference; Activity 2. describe the prerequisites for prescribing controlled substances in Texas; 3. explain the TMB guidelines on pain management; and 4. assess the roles, responsibilities, and compliance of staff and advanced practice providers. CME: Following TMB guidelines when providing pain management care COURSE AUTHOR PRICING Franklin Hopkins is an Austin-based attorney, The following fee will be charged when accessing Board Certified in Administrative Law by the this CME course online at http://tmlt.inreachce.com. Texas Board of Legal Specialization, with Germer Policyholders: $10 Beaman & Brown PLLC. His practice focuses on Non-policyholders: $75 medical malpractice defense and representing physicians before the Texas Medical Board, along ETHICS STATEMENT with representing other health care licensees in This course has been designated by TMLT for front of their respective licensing agencies. 1 credit in medical ethics and/or professional responsibility. DISCLOSURE Franklin Hopkins has no commercial INSTRUCTIONS affiliations/interests to disclose related to this the Reporter CME test and evaluation forms activity. must be completed online. After reading the article, go to http://tmlt.inreachce.com. Log in using your TARGET AUDIENCE myTMLT account information to take the course. This 1-hour activity is intended for physicians Follow the online instructions to complete the of all specialties who are interested in practical forms and download your certificate. If you do not ways to reduce the potential for medical liability. have a myTMLT account, please follow the on- screen instructions to create one. CME CREDIT STATEMENT Questions about the CME course? Please call Physicians are required to complete and pass a TMLT Risk Management at 800-580-8658. test in order to earn CME credit. A passing score of 70% or better earns the physician 1 CME credit. ESTIMATED TIME TO COMPLETE ACTIVITY TMLT is accredited by the Accreditation It should take approximately 1 hour to read this Council for Continuing Medical Education article and complete the questions and evaluation (ACCME) to provide continuing medical education form.