Your OMIC Coverage During Natural Disasters Such as the Ongoing Fires in Los Angeles

OMIC will honor coverage for emergency treatment of victims and evacuees of a national disaster such as a fire, earthquake, hurricane, tornado, or terrorist incident. Insureds in the directly affected areas should contact OMIC’s Underwriting Department at (800) 562-6642, option 1 for assistance in determining their coverage needs. Your underwriter will explain the different coverage options and recommendations for providing emergency medical care in your area. Insureds supporting recovery in surrounding non-affected areas will be covered under the OMIC policy for related volunteer medical care and should maintain full coverage for the scope of activities they expect to perform. If providing care in a different state or territory than which you are licensed, you should check the licensure provisions and requirements of your state of practice as well as the location where you will provide services.

Because state laws vary as to the application of the “Good Samaritan” rule, OMIC strongly recommends that all member-insureds treating patients who have been injured or traumatized as a direct result of a natural disaster or terrorist incident maintain (at least) basic documentation of any treatment rendered, including identifying information of the patient, a short narrative summary of the diagnosed condition, and specific medical care delivered. If a patient is unconscious or unable to communicate, the Good Samaritan law typically recognizes that patients would want life-saving (or vision-saving) treatment, which allows a Good Samaritan to provide care without explicit consent. However, the requirements vary by jurisdiction and the nature of the emergency.

Insureds who have been directly affected by a natural disaster or terrorist incident should contact OMIC as soon as is reasonable. OMIC’s staff will help determine the specific coverage needs on an individual basis and provide immediate solutions or recommendations. As a general rule, OMIC will not process cancellations for non-payment and will extend due dates as necessary. In certain circumstances, OMIC will waive the small premium normally required under policy suspension or make other accommodations on a case-by-case basis.

The type of follow-up care and the ability to provide such care will be determined by the surrounding circumstances (e.g. at a clinic, hospital or temporary medical center, or area). In any situation, ophthalmologists providing care to survivors should try to obtain current contact information and document the encounter. Keep a copy of the encounter note, arranged alphabetically in a file labeled “Care Provided to ____________ Disaster Victims”.

Given the likelihood that many patients will not be seen by you again, give the patient a copy of the examination/visit note and indicate on it:

1. Brief history;
2. Pertinent positive or negative findings from the physical examination;
3. The differential diagnosis; and
4. Treatment and follow-up recommendations, including the timeframe in which to obtain the treatment

Follow-up care may depend on where the patient was treated and what follow-up treatment is necessary e.g. hospitalization, referral to another physician, etc. If you are providing care in an office setting (yours or someone else’s office) and determine that the patient requires continuing care:

1. Determine if the patient will be able to return to the same location for follow-up care. If the patient will not, note that in the record and assume that you have no follow-up duty.
2. If the patient intends to return for care, schedule the follow-up appointment before the patient leaves.
3. If the patient is a no-show, ask staff to notify you. Staff should try to contact the patient using the last known information and attempt to reschedule the appointment. If unable to reach the patient, document that in the record and assume you have no further follow-up duty.

If possible, review your upcoming appointments to identify patients who need to be seen urgently. If you’re unable to provide care at your office, determine where you can see those patients, such as at a hospital, urgent care center, or another practice. Consider if a telehealth visit is an option. Attempt to contact those patients and advise them where and when you can provide the care, and document those discussions. You may also want to post a statement on your practice social media accounts to inform patients how you’re handling appointments, prescriptions, and scheduled procedures, and provide the best way to contact your office.

Contact your electronic medical records vendor for assistance in restoring your data.

Try to salvage any records. If you use a damage restoration company, you should have a business associate agreement with that company to ensure that any and all services are performed in accordance with the HIPAA privacy and security rules for third party contractors.

Often state and local governments will allow physicians to attest that the record was lost / destroyed due to a natural disaster, especially if the governor had proclaimed the fire damage incurred a “disaster emergency”. It allows physicians to go forward from that point in establishing a medical record without the concern that remnants of that patient record could end up in the hands of an unauthorized person.

Some of your patients may have lost their medications during the disaster, be due for a refill, or may have a new problem for which they are requesting medication. Local pharmacies who have access to their records should be able to provide you with information regarding refills. Create a record to document refills and new prescriptions, and follow your customary prescribing practices.