Privately Practising Midwives and Insurancethat Underpins CollaborationThursday 21 June 20124th Annual Obstetric Malpracti...
Monday, 25 June 20122Agenda MIGA– Our services and experience■ Midwives Insurance Scheme framework Overview of the cover...
Monday, 25 June 20123MIGA Specialist niche insurer – in business more than 100 years Core business Medical and Professio...
Federal Government Scheme
Monday, 25 June 20125Federal Government SchemeMIGA is the sole provider under the Scheme We must work within a legislativ...
Monday, 25 June 20126Do midwives have to insure?■ Yes - it‟s the law! Requirement under National Registration andAccredit...
Monday, 25 June 20127Who is an eligible midwife?■ Licensed, registered or authorised to practise midwifery – with norestri...
Cover available to midwives
Monday, 25 June 20129What does MIGA provide?MIGA provides 3 layers of support■ Cover for:– Claims for compensation and leg...
Monday, 25 June 201210Two options for cover Option A– Midwives who provide intrapartum care in theirprivate practice– In ...
Monday, 25 June 201211Limit of the coverCover provided jointly byMIGA and the Commonwealth MIGAs policy limit is $2m per ...
Monday, 25 June 201212Cost of the coverFixed by agreement with the Federal Government Maximum “full time” cost Reduction...
Key conditions of the cover
Monday, 25 June 201214Key conditions of cover Only available to eligible (registered) privately practisingmidwives Cover...
Monday, 25 June 201215Key conditions of cover cont Care must be provided as part of a– Collaborative Arrangement or,– Car...
Monday, 25 June 201216Key conditions of cover cont Comply with ACM‟s National MidwiferyGuidelines for Consultation and Re...
Monday, 25 June 201217What if midwife is employed?They can still be covered providedThey are employed (full or part-time) ...
Monday, 25 June 201218Important access to run-off coverCover provided is on a “Claims Made” basis Only covers claims made...
Monday, 25 June 201219Benefits of ROCS Only MIGA‟s policy provides access to FederalGovernment Run-Off scheme– Called “RO...
Effective collaboration betweenobstetricians and midwives
Monday, 25 June 201221BarriersTo practicing as an eligible midwife, being able to offer fullrange of midwifery services an...
Monday, 25 June 201222Making collaboration work■ We insure obstetricians and midwives■ We support effective collaboration–...
Monday, 25 June 201223Some practical tips■ Consider having collaborative arrangement in writing■ Make sure you have addres...
Questions
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Privately Practising Midwives and the Insurance that Underpins Collaboration

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Mandy Anderson, Chief Executive, from MIGA has presented at the Obstetric Malpractice Conference. If you would like more information about the conference, please visit the website: http://bit.ly/10xh1iO

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Privately Practising Midwives and the Insurance that Underpins Collaboration

  1. 1. Privately Practising Midwives and Insurancethat Underpins CollaborationThursday 21 June 20124th Annual Obstetric Malpractice Conference
  2. 2. Monday, 25 June 20122Agenda MIGA– Our services and experience■ Midwives Insurance Scheme framework Overview of the cover available to midwives Key conditions of the cover Effective collaboration between obstetricians andmidwives Questions.
  3. 3. Monday, 25 June 20123MIGA Specialist niche insurer – in business more than 100 years Core business Medical and Professional indemnity for– Doctors, medical students, midwives and corporate entities Extensive experience & knowledge of medical & legal systemincluding obstetrics More than an insurer - Support services– Medico-legal support and advice– Risk management– Practitioners‟ Support Service Head office – Adelaide– Branches in Sydney, Melbourne and Brisbane.
  4. 4. Federal Government Scheme
  5. 5. Monday, 25 June 20125Federal Government SchemeMIGA is the sole provider under the Scheme We must work within a legislative framework We must comply with Federal Governmentrequirements for the:– Cover we can provide– Conditions we work within– Cost of cover.
  6. 6. Monday, 25 June 20126Do midwives have to insure?■ Yes - it‟s the law! Requirement under National Registration andAccreditation Scheme (NRAS)– From 1 July 2010 privately practising midwives musthave appropriate insurance Exemption from insuring for provision of intrapartum carefor planned homebirths All other midwifery practice must be covered byappropriate insurance Cover available under Federal Government Scheme forEligible Midwives.
  7. 7. Monday, 25 June 20127Who is an eligible midwife?■ Licensed, registered or authorised to practise midwifery – with norestrictions on practice■ Completed at least 3 years of post-registration practice (across thecontinuum of midwifery care) within previous 5 years■ Completed an approved professional review program for midwives(across continuum of midwifery care)■ Completed 20 additional hours of continuing professional development(across continuum of midwifery care)■ Completed (or undertakes to Board to complete within an agreedtimeframe):– Accredited and approved program to develop knowledge and skills inprescribing, or– Program substantially equivalent, as determined by the NMBA.
  8. 8. Cover available to midwives
  9. 9. Monday, 25 June 20129What does MIGA provide?MIGA provides 3 layers of support■ Cover for:– Claims for compensation and legal costs– Expenses and support in the event of enquiries■ 24 hour emergency advice and support■ Package of risk management resources– Free risk management education program (premiumdiscount on completion)– CPD points– Risk Resources – on-line risk management tools, factsheets and resources.
  10. 10. Monday, 25 June 201210Two options for cover Option A– Midwives who provide intrapartum care in theirprivate practice– In addition to antenatal and postnatal care■ Option B– Midwives who only provide antenatal andpostnatal care– Provide no intrapartum care in their privatepractice.
  11. 11. Monday, 25 June 201211Limit of the coverCover provided jointly byMIGA and the Commonwealth MIGAs policy limit is $2m per claim– Commonwealth contribution– 80% of claims between $100,000 and $2m Midwives covered for claims > $2m by Federal Government Claim managed by MIGA irrespective of amountEligible Midwives are effectively covered for an unlimitedsum.
  12. 12. Monday, 25 June 201212Cost of the coverFixed by agreement with the Federal Government Maximum “full time” cost Reductions for „part time” costPer year Intrapartum CareOption ANo Intrapartum CareOption BFull time i.e. 40 women ormore$7,500 $3,40030 to 39 women $6,500 $3,00015 to 29 womenwomen$5,000 $2,250Fewer than 15 women $3,375 $1,530
  13. 13. Key conditions of the cover
  14. 14. Monday, 25 June 201214Key conditions of cover Only available to eligible (registered) privately practisingmidwives Cover is only for care provided to:– Private patients– In Australia There is no cover for:– Care provided to public patients– Intrapartum care for planned home births– Care before 1 July 2010 (or date of inception if later)– Midwifery services provided in course of employment(other than in certain situations).
  15. 15. Monday, 25 June 201215Key conditions of cover cont Care must be provided as part of a– Collaborative Arrangement or,– Care Plan communicated to a Public Hospitalproviding obstetric services■ In relation to cover Option B (cover for antenatal careand postnatal care only)– No cover for intrapartum care– If at any time you provide intrapartum care as part ofyour private practice– Except in an unforeseen emergency situation
  16. 16. Monday, 25 June 201216Key conditions of cover cont Comply with ACM‟s National MidwiferyGuidelines for Consultation and Referral or– If working in collaboration either ACM orRANZCOG guidelines– Particularly in relation to discussion,consultation and referral Suitably qualified and authorised (as determinedby the NMBA) for prescribing.
  17. 17. Monday, 25 June 201217What if midwife is employed?They can still be covered providedThey are employed (full or part-time) by a company that is: Owned solely by them, or Owned solely by practising midwives including them– and where the only directors of that company arethem and other practising midwives
  18. 18. Monday, 25 June 201218Important access to run-off coverCover provided is on a “Claims Made” basis Only covers claims made and reported during policyperiod No cover after policy ceases Run-off covers midwife for claims made in future whichrelate to incidents that occurred in their prior practice Need to maintain run-off cover after they cease practiceto be protected against claims that may arise in thefuture Note: The National Law requires run-off cover ismaintained after the midwife ceases practise.
  19. 19. Monday, 25 June 201219Benefits of ROCS Only MIGA‟s policy provides access to FederalGovernment Run-Off scheme– Called “ROCS” Scheme is funded via a levy of 10% on premiums Access to Scheme following:– Permanent retirement after age 65– Death or permanent disability– If ceasing practice before age 65 – will cover from 3years after they cease– Maternity leave - temporarily or permanently.
  20. 20. Effective collaboration betweenobstetricians and midwives
  21. 21. Monday, 25 June 201221BarriersTo practicing as an eligible midwife, being able to offer fullrange of midwifery services and accessing the Govtinsurance scheme Requirement for collaboration and care plans – thesehave proven difficult to achieve Lack of access agreements for midwives to provideintrapartum care in public hospitals Cost of the product.Lack of insurance for home births.
  22. 22. Monday, 25 June 201222Making collaboration work■ We insure obstetricians and midwives■ We support effective collaboration– There is no issue in terms of insurance cover– We see this form of collaboration as no different toany others we insure■ We have provided guidance to our clients on how tounderpin this with an agreement■ Will soon have on our website a draft Collaborativeagreement that any doctor or midwife can use.
  23. 23. Monday, 25 June 201223Some practical tips■ Consider having collaborative arrangement in writing■ Make sure you have addressed in advance– Communication protocols– Clinical settings where the services will be provided– Roles of each party– Protocols for consultation, referral and transfer including in anemergency situation– Arrangements for initiating pathology and diagnostic imaging tests– Arrangements for sharing information from patient‟s medical record– Prescribing arrangements and protocols– What will happen in the event of absences– The basis for charging and recoupment of out of pocket expenses.
  24. 24. Questions
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