Relias Media - Continuing Medical Education Publishing

The trusted source for

healthcare information and

CONTINUING EDUCATION.

  • Sign In
  • Sign Out
  • MyAHC
    • Home
      • Home
      • Newsletters
      • Blogs
      • Archives
      • CME/CE Map
      • Shop
    • Emergency
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Hospital
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Clinical
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • All Access
      • My Subscription
      • Subscribe Now
    • My Account
      • My Subscriptions
      • My Content
      • My Orders
      • My CME/CE
      • My Transcript
    Home » Fair Hearing Process Can Require Outside Help

    Fair Hearing Process Can Require Outside Help

    April 1, 2018
    No Comments
    Reprints
    Facebook Twitter Linkedin Share Share

    Related Articles

    Outside experts can help with capital campaign

    Inquiry process can help build leaders

    Testing 1, 2, 3: Help protect workers’ hearing

    Related Products

    Outside experts can help with capital campaign | Single Article

    Take-home exposures can pose threat outside work | Single Article

    Exactly when an “investigation” begins under hospital bylaws can be crucial in the peer review process, says John C. Ivins Jr., JD, partner with the Hirschler Fleischer law firm in Richmond, VA.

    Hospital leaders should craft bylaws with their legal counsel that establish informal measures in a way that does not constitute initiating an investigation, he says. This can help avoid dilemmas regarding reports to the National Practitioner Data Bank (NPDB) and triggering the fair hearing process.

    Often, once a matter has gone into extensive peer review, the hospital may conclude it would be best if the practitioner left the medical staff, Ivins notes, or the physician may conclude that his or her credibility has been questioned so much that it would be better to seek a position elsewhere.

    “An impediment that can arise is where the physician is already considered to be under investigation. In that case, he or she cannot resign without the hospital having to file a data bank report reflecting that the physician resigned while under investigation,” Ivins says. “Where efforts in informal resolution can be undertaken at an early stage, more options that are not considered being under investigation may be available for resolution. Otherwise, a fair hearing may end up being requested because the physician and his or her counsel find that an investigation is now underway.”

    Fair hearings are incredibly disruptive not only to the hospital and the medical staff, but to the hospital’s administrative office, Ivins says. Most hospitals do not encounter fair hearings very often, so they are unfamiliar with the fair hearing plan and its many requirements, including specific notices, notice periods, contents of letters, and processes.

    “One of the biggest problems hospitals face once the peer review process has gotten to this point is its failure to follow the strict requirements of its bylaws and related fair hearing plans,” Ivins says. “The implications can be disastrous because such failures can result in losing the protections afforded under HCQIA.”

    The best way to address a fair hearing and to avoid many of these problems is to involve hospital counsel early, Ivins says. Experienced hospital counsel can ensure that the hospital follows all legal and contractual requirements and that the fair hearing process provides the due process that is to be afforded to the physician seeking the hearing.

    Another way to address the process and ensure a smooth, fair hearing is to engage an outside hearing officer to manage the process, Ivins says. Under most fair hearing plans, the hospital has the right to select a hearing officer to handle all issues of pre-hearing process, questions of discovery of information, and similar issues.

    The physicians appointed to serve on a hearing panel are not generally comfortable serving in such a role and often do not understand their roles, Ivins notes. An outside hearing officer educates the appointed panel members concerning their roles as addressed in the bylaws and applicable law.

    The panel is separate from the medical executive committee, Ivins explains. It should have its own counsel, and typically the hearing officer serves in this role. This may depend upon the language of the bylaws and the hearing plan.

    During the fair hearing, the hearing officer makes procedural and other rulings consistent with the scope of his or her role as defined in the bylaws and hearing plan, Ivins says. Once the hearing is concluded, the hearing officer typically will assist the panel in preparing its report and recommendations to the medical executive committee.

    “The expertise of the panel members is in the needed clinical and other assessments they provide, not in the preparation of a hearing report and recommendation,” Ivins says. “The latter is much more the skillset of an experienced healthcare lawyer or hearing officer. By involving legal counsel to advise the hospital and medical executive committee at an early phase and by engaging an outside hearing officer to advise the hearing panel and handle the mechanics and process of the hearing, the hospital can greatly reduce problems that can otherwise arise in the fair hearing process.”

    Post a comment to this article

    Report Abusive Comment

    www.reliasmedia.com

    Hospital Peer Review

    View PDF
    Hospital Peer Review (Vol. 43, No. 4) - April 2018
    April 1, 2018

    Table Of Contents

    Legal Risks Abound in Peer Review; Good Process Required

    Four Rules to Follow in Peer Review

    Fair Hearing Process Can Require Outside Help

    Avoid ‘Hypothetically’ and Lounge Gossip

    Strict Safety Briefings Reduce CAUTIs, CLABSIs, and Falls

    CAUTIs More Expensive Than Previously Thought

    CHI Goes to Data to Improve Quality and Safety

    Begin Test

    Buy this Issue

    Feedback? Take Our Quick Reader Survey

    Financial Disclosure: Author Greg Freeman, Editor Jesse Saffron, Editor Jill Drachenberg, Nurse Planner Amy M. Johnson, Editorial Group Manager Terrey L. Hatcher, and Consulting Editor Patrice Spath report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.

    Shop Now: Search Products

    • Subscription Publications
    • Books & Study Guides
    • Webinars
    • Group & Site
      Licenses
    • State CME/CE
      Requirements

    Webinars And Events

    View All Events
    • Home
      • Home
      • Newsletters
      • Blogs
      • Archives
      • CME/CE Map
      • Shop
    • Emergency
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Hospital
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Clinical
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • All Access
      • My Subscription
      • Subscribe Now
    • My Account
      • My Subscriptions
      • My Content
      • My Orders
      • My CME/CE
      • My Transcript
    • Help
    • Search
    • About Us
    • Sign In
    • Register
    Relias Media - Continuing Medical Education Publishing

    The trusted source for

    healthcare information and

    CONTINUING EDUCATION.

    Customer Service

    customerservice@reliasmedia.com

    U.S. and Canada: 1-800-688-2421 x 2

    International +1-404-262-5476 x 2

    Accounts Receivable

    1-800-688-2421 x 3
    ReliasMedia_AR@reliasmedia.com

    Sales

    1-800-688-2421 x 1

    Mailing Address

    • 1010 Sync St., Suite 100
      Morrisville, NC 27560-5468
      USA

    © 2022 Relias. All rights reserved.

    Do Not Sell My Personal Information  Privacy Policy  Terms of Use  Contact Us  Reprints  Group Sales

    For DSR inquiries or complaints, please reach out to Wes Vaux, Data Privacy Officer, DPO@relias.com

    Design, CMS, Hosting & Web Development :: ePublishing