Transfer Agreement Issues

Transfer agreements are written plans that exist between hospitals or between hospitals and transport services that define the roles, understand­ings, and procedures for moving patients from one facility to another.

One of the main reasons for transfer agreements is to create a smooth­working transfer system that serves the needs of all participants and helps set the expectations and standards of all parties. For patients, transfer agree­ments attempt to make care more efficient with the least risk of adverse outcome. For hospitals and transfer services, agreements allow participants to understand how the system is to work, what responses to expect, and how payment is to be addressed before actual need. Legal counsel is recom­mended to ensure the agreements meet state requirements and do not con­tain clauses with unintended risks. If state-mandated agreement forms are used, legal counsel should review them for compliance.

Liability Issues With Transfer Agreements

Transfer agreements seldom produce liability, except for issues pertaining to payment. If a transfer agreement provides that payment for transfers will be guaranteed by the hospital if insurance, Medicaid, or Medicare fails to pay or pays less than a specific percentage of the transport service bill and the hospital refuses to pay when properly billed, one can expect that liability might result from the contract.

If the transport service promises a specific response time or specific response personnel under given circumstances for a given price, it is likely that financial liability issues would be involved if the transport service failed to meet the conditions of the contract. If that failure resulted in harm to a patient, the hospital might cross-claim against the transport service if a medical malpractice case arose because of the lack of an appropriate and expected response. Patients can also sue directly for the breach, maintaining that patients were the parties intended to be served or protected (third-party beneficiary) by the contract terms.

The liability exposure of the transfer agreement seldom creates new liability, however, because the contract terms are usually carefully drawn to make the service conditional on availability, capacity, and other provisions to make the agreement a more nonbinding understanding than a document on which liability would rest.