7. AUTOMATIC RELINQUISHMENT OF CLINICAL PRIVILEGES
8. NOTICE
9. PRE-HEARING DISCOVERY
10. THE HEARING OFFICER OR TRIBUNAL
11. ROLE OF LEGAL COUNSEL
12. PRESENTATION OF THE CASE
13. MAKING A HEARING RECORD
14. PRACTICAL TIPS FOR CONCLUDING THE HEARING
15. THE HEARING PANEL'S DECISION
16. APPELLATE REVIEW AND FINAL BOARD DECISION
17. REC0NCILING HCQIA AND STATE LAW
18. INJUNCTIONS CHALLENGING PEER-REVIEW ACTIONS
19. HIPAA PRIVACY RULE CONSIDERATIONS
APPENDIX A: CASES WHERE PHYSICIANS ALLEGED VIOLATIONS OF THE ADA
APPENDIX B: CASES DEALING WITH BEHAVIORAL ISSUES
APPENDIX C: EXCLUSIVE-CONTRACT CASES
APPENDIX D: HCQIA CASES
APPENDIX E: BASES FOR CORRECTIVE ACTION
APPENDIX F: ILLUSTRATIVE SUMMARY-SUSPENSION CASE
The newly updated Fourth Edition of Peer Review Guidebook is a comprehensive resource for understanding the peer review process and disciplinary proceedings involving physicians. Edited by Daniel Mulholland, Esq., Lauren M. Massucci, Esq., and Charles J. Chulack, Esq., this updated edition contains information about the new Joint Commission standards on Focused Professional Practice Evaluation and Ongoing Professional Practice Evaluation, a discussion of the Patient Safety and Quality Improvement Act, as well as the latest from the National Practitioner Data Bank.
As did the previous editions, this one reviews the threshold issues, presents analysis of the Health Care Quality Improvement Act (HCQIA) and its impact on the peer review process, offers guidance in the selection and compensation of hearing panel members, provides information about injunctive relief from peer review actions, and discusses the effect that the privacy rule of the Health Insurance Portability and Accountability Act (HIPAA) has on peer review. The title also provides a multitude of citations to cases, regulations, and other sources.
The Peer Review Guidebook also addresses: recognizing and characterizing the issues; informal dispute resolution; suspension of privileges; the formal hearing process; utilization of legal counsel by both sides; presentation of the case; reporting requirements; and reconciling reality with HCQIA and applicable state laws and regulations. The appendices include a listing of cases in which physicians have alleged violations of the American Disabilities Act (ADA), cases dealing with physician-behavior issues, a comprehensive list of exclusive-contract case law, and cases decided under HCQIA.
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