5 Biggest Ketamine Clinic Professional Insurance Misconceptions
Insurance is one of the most misunderstood aspects of running a ketamine clinic. Owners and practitioners often believe standard coverage is enough. In reality, the wrong assumptions can expose clinics to significant risk.
This is one of the reasons we launched the Healing Health Alliance GPO. We have seen many clinics we work with not have the coverage they think they are paying for. Our insurance partners have created tailored policies specifically for ketamine clinic owners and practitioners. Interested in learning more? There’s no cost to join and zero obligations after joining. Sign up here!
| Misconception | Reality | Action Step |
|---|---|---|
| Standard malpractice policies cover ketamine therapy | Many exclude off label treatments and require specialized riders | Review policy language for ketamine exclusions |
| Workers compensation automatically covers ketamine related injuries | Coverage varies by state and requires specific protocols | Verify coverage through our GPO for ketamine administration procedures |
| General liability protects against all clinic risks | Certain specialized policies may be needed for comprehensive protection | Conduct full risk assessment with insurance broker |
| Standard disability insurance remains unchanged for ketamine practitioners | Off-label prescribing may affect coverage terms | Disclose ketamine practice to disability insurer |
| High priced coverage from national brand providers is sufficient for all Professional Liability needs. | Ketamine coverages are becoming increasingly nuanced working with experienced professionals becomes essential | Work with our HHA GPO insurance providers to get the specialized malpractice and liability coverage your clinic needs for peace of mind. |
Misconception 1: Standard Malpractice Policies Cover All Ketamine Treatments
The most dangerous misconception assumes existing medical malpractice insurance automatically covers ketamine therapy. Many policies contain exclusions for off label drug use, leaving practitioners financially exposed to malpractice claims. If you are a medical professional offering ketamine infusions, intramuscular ketamine, ketamine nasal spray, or ketamine lozenges through your private practice or a specialized clinic, your existing malpractice policy likely doesn’t cover these protocols.
Work with our HHA GPO to create bulletproof treatment regimes . We work with clinics across the country and our leadership advises J&J on Spravato applications. We can help you develop best in class clinic processes.
Insurance companies scrutinize ketamine claims because they don’t understand psychedelic protocols. Establishing a consistent standard of care to cover can be challenging due to the lack of standardized treatment protocols. This uncertainty makes malpractice claims more likely and settlements more expensive.
Many insurers require specific forms for interventional treatments including ketamine infusion. Many malpractice carriers have a specific form that needs to be submitted by practices and clinicians that plan to offer TMS or other interventional treatments, including ketamine infusion. The form usually requires detailed information regarding your processes for clinician and technician training, informed patient consent, safety procedures in the event of a medical emergency, and management of services that are used for off label indications.
Some practitioners face coverage denials because of split treatment models. Recently, some practitioners have been denied coverage, because of their split treatment models. This occurs when a physician or nurse practitioner prescribes ketamine (IV, IM, or troches), and another therapist provides the actual ketamine assisted therapy.
The coverage we will provide thru the HHA GPO Insurance group wraps the administration of the medicine with comprehensive psychedelic assisted therapy so your patients get the best care and you have the broadest type of insurance
RELATED: Solving the Insurance Puzzle: How to Get Your Ketamine Therapy Covered
Misconception 2: Workers Compensation Automatically Covers Ketamine Administration
Clinic owners assume workers compensation insurance automatically protects employees during ketamine treatments. This misconception creates significant liability gaps when staff suffer injuries while handling controlled substances or assisting disoriented patients. In most states, employers are legally required to maintain workers’ compensation insurance for their employees. Even where not legally required, it may be good to have.
Workers compensation coverage varies dramatically based on state regulations and specific treatment protocols. Workers compensation insurance is mandatory in most states. It covers medical expenses and lost wages for employees who are injured on the job, and it’s crucial for any business with employees.
However, coverage for ketamine related workplace injuries requires specific documentation and protocols. Insurance companies want proof that proper safety measures protect staff from exposure to controlled substances, patient behavioral incidents, and medical emergencies during treatment sessions.
Practitioners should consider workers compensation even for independent contractors. If a practitioner employs others, the practitioner should consider obtaining workers’ compensation insurance even if that practitioner only works with 1099 employees. This type of insurance is usually not that expensive, and the costs of not having it could be significant.
By working with HHA’s GPO Insurance team you can be assured that you will have all of the required documentation and will full training on the on all insurance mandated protocols.
Do you work in the ketamine industry? Save thousands on overhead and other fees by joining the first GPO for ketamine clinics and practitioners. We also have insurance policies tailored to your needs. There’s no cost to join and zero obligations. Sign up here!
Misconception 3: General Liability Provides Comprehensive Protection
Many ketamine clinic owners believe general liability insurance covers all potential business risks. This oversimplification ignores the complex liability landscape that ketamine clinics navigate daily. Patients entering a ketamine clinic pose a risk of experiencing accidental injuries, such as slip and fall injuries. In addition, on the job accidents need to be covered to compensate for liability claims related to the overall safety of the ketamine clinic.
General liability policies typically exclude professional services, requiring separate professional liability coverage. These policies may cover physical injuries on premises but not treatment related complications or professional negligence claims.
Ketamine clinics face unique advertising liability risks. Allegations of misleading statements about ketamine therapy and its effectiveness can lead to legal actions for false advertising.
Cybersecurity risks create additional exposure. Cyberattacks have become commonplace in all walks of daily life, and the risks in this area are especially high for ketamine clinics. Breaches that provide access to Electronic Health Records (EHRs) can lead to significant legal and financial consequences.
Misconception 4: Disability Insurance Terms Remain Unchanged
Practitioners assume their existing disability insurance continues unchanged when adding ketamine therapy services. This misconception can lead to claim denials when disability insurers discover undisclosed changes in practice scope or risk profile.
Off label prescribing and controlled substance administration may trigger policy review requirements. Disability insurers evaluate risk based on specialty, procedures performed, and liability exposure. Ketamine therapy substantially changes these risk factors.
Professional disability policies often contain exclusions for claims arising from specific treatments or procedures not disclosed during application. Practitioners must notify insurers about ketamine therapy to maintain coverage validity.
The emerging nature of ketamine therapy creates uncertainty in disability insurance underwriting. Some insurers may request additional information about treatment protocols, safety measures, and malpractice coverage before continuing coverage.
HHA’s GPO Insurance Team can help you navigate thru this minefield and has access to unique LTD covers tailored to your needs.
Do you work in the ketamine industry? Save thousands on overhead and other fees by joining the first GPO for ketamine clinics and practitioners. We also have insurance policies tailored to your needs. There’s no cost to join and zero obligations. Sign up here!
Misconception 5: Professional Insurance Costs Remain Predictable
The final major misconception assumes ketamine therapy adds minimal cost to professional insurance programs. Reality proves far more expensive as specialized coverage requirements and higher risk profiles drive premium increases. Using medication off label comes with increased risk, and the expanded availability of Ketamine Therapy over the past few years has led to the emergence of ketamine related medical malpractice lawsuits.
Medical malpractice premiums continue rising across specialties, with ketamine practitioners facing additional increases. Rates are expected to climb another 5% to 20% this year. Providers in litigious states and high risk specialties will bear the brunt of these increases.
Ketamine therapy creates multiple insurance needs requiring separate policies. Professional liability, general liability, cyber liability, workers compensation, and umbrella coverage combine to create substantial annual premiums that traditional practices never encounter.
Limited carrier options drive higher costs. With claims costs rising, many smaller insurers struggled to stay competitive. Larger players consolidated their market share, leaving fewer options for coverage.
Insurance companies require extensive documentation about treatment protocols, safety measures, and staff training. To determine the risk associated with practicing ketamine therapy, insurers may ask for a copy of the insured’s prescribing protocol, including the first dosage administered and quantities prescribed at once.
HHA’s Insurance GPO team knows the risks inherent in ketamine medical practices having worked in the space for many years and after having developed some of the first specialty covers for psychedelics . We’ll provide a free consultation to layout the best options for you given the specifics of your practice. Shoot us an email at [email protected].
Building Comprehensive Protection
Understanding professional insurance realities enables ketamine practitioners to build appropriate protection programs. The specialized nature of ketamine therapy demands comprehensive coverage that traditional medical practices rarely require.
Start working today with our HHA Team — the strongest and deepest ketamine risk management firm in the market. Save thousands on overhead and other fees by joining the first GPO for ketamine clinics and practitioners. We also have insurance policies tailored to your needs. There’s no cost to join and zero obligations. Sign up here!
