When the Environmental Protection Agency (EPA) recently announced its first-ever regulation of acceptable drinking water levels for six per- and poly-fluoroalkyl substances (PFAS), which are often referred to as "forever chemicals," it underscored the public’s growing concern about the long-term health effects of toxic substances in the air we breathe, the food we eat, and the water we drink. 

Whether exposure happens in dramatic fashion, such as through an oil spill, or more subtly over time by companies quietly contaminating the soil and groundwater, we believe the demand for medical monitoring programs will continue to increase, as communities grapple with these issues.

When considering whether a medical monitoring program may be appropriate in a particular situation, stakeholders should recognize the importance of working with an expert early in the process, seeking solutions that closely model medical providers’ typical processes, and knowing their options.

1. Work with an expert from the beginning

The concept of offering medical monitoring can seem straightforward at first, but thinking through the multitude of variables can quickly become overwhelming. Partnering with a reputable administrator from the beginning is vital.

While negotiating the terms of a settlement, parties can be inundated with demands and questions from the other side and from their own teams regarding the benefits, costs, and feasibility of various options – often with little historical or publicly available data to rely on.

Retaining an expert through this process helps parties consider all the possible permutations of a program, including aspects such as eligibility criteria, services offered, program duration, and frequency of testing. An expert can also help identify which potential benefits are most valuable to program participants and model potential costs and other considerations, providing clarity as parties contemplate their options.

2. Align the program’s processes as closely as possible to the way providers normally operate

Maintaining satisfaction within a medical monitoring program’s provider network is a critical component of successfully administering this type of program. Put simply: Without a provider network, the program does not exist.

Although any administrator’s first responsibility is adherence to its obligations under the program’s governing documents, the administrator should seek to align its processes with those of providers as much as possible.

For example, using the same Current Procedural Terminology (CPT) codes that providers typically use for the types of evaluations called for in the program can help align the program’s billing processes more closely with the providers’ typical billing processes. 

Taking this approach can go a long way in building the types of collaborative, long-term relationships between an administrator and providers that are essential to the program’s success and participants’ well-being.

3. Know your options

It is a common misconception that there are jurisdictions where medical monitoring cannot be offered. Some states do permit medical monitoring programs as a remedy as part of a judgement, others do not, and in some states the question has not been resolved. However, medical monitoring can be offered anywhere as part of a legal settlement. 

So, as litigants engage in pre-settlement negotiations, there is no reason to reflexively rule out medical monitoring as a potential benefit in a negotiated settlement, even in jurisdictions where medical monitoring cannot be pursued as a remedy in a judgement.

In situations where medical monitoring can make a real difference in people’s lives, bringing in experts is a wise investment. Doing so can save both time and money and can ensure that the resulting program is both cost-effective and a true benefit to the participants.

Jon Paschal is a senior director of product development for Epiq’s class action and mass tort solutions team. He created and implemented Epiq’s first medical monitoring and consulting services offerings and has overseen large-scale and complex medical monitoring programs.