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  • Question

    Does FAR 52.237-7, Indemnification and Medical Liability Insurance, apply for these services. If so, does it apply for all these services or just one specialty (e.g. Physical Therapists)? Is there a standard minimum amount required for medical liability insurance or is it determined based on the State where services are rendered?


    Answer

          FAR 37.403 states, "The contracting officer shall insert the clause at 52.237-7, Indemnification and Medical Liability Insurance, in solicitations and contracts for nonpersonal health care services."  FAR 37.400 states, "This subpart prescribes policies and procedures for obtaining health care services of physicians, dentists and other health care providers by nonpersonal services contracts, as defined in 37.101."  I could not find a definition of "other health care provider" in the FAR but, CFR Title 29, Subtitle B, Chapter V, Subchapter C, Part 825, Subpart A, Section 825.125, defines health care provider as follows:

                  (a) The Act defines health care provider as (The Family and Medical Leave Act):

                 (1) A doctor of medicine or osteopathy who is authorized to practice  medicine or surgery (as appropriate) by the State in which the doctor practices; or

                  (2) Any other person determined by the Secretary to be capable of providing health care services.

                  (b) Others capable of providing health care services include ONLY:

                  (1) Podiatrists, dentists, clinical psychologists, optometrists, and chiropractors (limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by X-ray to exist) authorized to practice in the State and  performing within the scope of their practice as defined under State law;

                  (2) Nurse practitioners, nurse-midwives, clinical social workers and physician assistants who are authorized to practice under State law and who are performing within the scope of their practice as defined under State law;

                  (3) Christian Science Practitioners listed with the First Church of Christ, Scientist in Boston, Massachusetts. Where an employee or          family member is receiving treatment from a Christian Science practitioner, an employee may not object to any requirement from an employer that the employee or family member submit to examination (though not treatment) to obtain a second or third certification from a health care provider other than a Christian Science practitioner except as otherwise provided under               applicable State or local law or collective bargaining agreement;

                  (4) Any health care provider from whom an employer or the employer's group health plan's benefits manager will accept certification of the existence of a serious health condition to substantiate a claim for benefits; and

                  (5) A health care provider listed above who practices in a country other than the United States, who is authorized to practice in accordance with the law of that country, and who is performing within the scope of his or her practice as defined under such law.

                  (c) The phrase authorized to practice in the State as used in this section means that the provider must be authorized to diagnose and treat physical or mental health conditions. (https://www.law.cornell.edu/cfr/text/29/825.125)

         I also did a google search and found the following definition of health care provider:

                  Under federal regulations, a "health care provider" is defined as: a doctor of medicine or osteopathy, podiatrist, dentist,  chiropractor, clinical psychologist, optometrist, nurse practitioner, nurse-midwife, or a clinical social worker who is authorized to  practice by the State and performing within the scope of their practice as defined by State law, or a Christian Science practitioner. A health care provider also is any provider from whom the University or the employee's group health plan will accept medical               certification to substantiate a claim for benefits. (https://hr.berkeley.edu/node/3777)

         The services in your contract do not appear to fit any of these definitions, and I could not find a definition in the FAR, so based on my research, it doesn't appear the clause in question would apply to your contract, but it might be a good idea to check with your state to determine if any of these types of services are classified as health care providers in your state and discuss it with medical professionals from your own base hospital or clinic. 

         To answer your next question regarding whether there is a "standard minimum", I could not find one in the FAR, but FAR 37.401(d) does say that "the contract shall require that the contractor maintain medical liability insurance, in a coverage amount acceptable to the contracting officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned."

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