The Complete Medical Staff, Peer Review, and Hearing Guidebook (Non-Members)

Updated and expanded beyond the scope of its predecessor works, The Complete Medical Staff, Peer Review, and Hearing Guidebook addresses trends toward informal resolution, increased integration, growing reliance on allied health professionals, and much more.

Publisher: AHLA

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ISBN: 9781663334695
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The Complete Medical Staff, Peer Review, and Hearing Guidebook reflects an experienced and practical approach that can be honed only through many years of practice. The authors and their predecessors have refined their approach to this critical subject over the course of eleven previous editions of three longstanding AHLA titles: The Medical Staff Guidebook, Peer Review Guidebook, and Peer Review Hearing Guidebook.

In this conveniently combined work, readers will find a concise and comprehensive discussion of issues commonly faced by attorneys and others working in and around the interdependent relationship of a health care entity and its medical staff. The authors examine this complex relationship from both practical and legal perspectives. From application to separation, this work provides analysis, cautions, recommendations, and examples of provisions for bylaws and associated documents.

Also included in this title are these valuable downloadable Appendices, which provide important information in a succinct, time-saving format for busy attorneys and medical practitioners:

  • Health Care Quality Improvement Act Cases
  • Keystones of A Peer Review Investigation
  • Sample Fair Hearing and Appellate Review Plan
  • Sample Investigation Report
  • Letter to Practitioner Regarding Adverse Recommendation and Right to Hearing
  • Letter to Practitioner Regarding Hearing Date and Hearing Rights
  • Hearing Officer Checklist
  • Outline for Hearing Committee Report
  • Sample Index for Medical Staff Hearing Exhibit Book
  • Sample Application Materials

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Published May, 2022.

 

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Table of contents

 PART I  MEDICAL STAFF

CHAPTER 1  INTRODUCTION: HISTORICAL PERSPECTIVE ON THE MEDICAL
 STAFF/HOSPITAL RELATIONSHIP

CHAPTER 2  BASIC STATUTORY, REGULATORY, AND ACCREDITATION MATTERS

CHAPTER 3  HEALTH CARE QUALITY IMPROVEMENT ACT OF 1986

CHAPTER 4  UNDERLYING LEGAL AND BUSINESS ISSUES IMPACTING THE
 HOSPITAL/MEDICAL STAFF RELATIONSHIP

CHAPTER 5  ORGANIZATIONAL AND DRAFTING TIPS FOR MEDICAL STAFF
 BYLAWS AND RELATED DOCUMENTS

CHAPTER 6  KEY PROVISIONS OF HEALTH CARE ENTITY BYLAWS

CHAPTER 7  OVERVIEW OF MEDICAL STAFF BYLAWS

CHAPTER 8  CREDENTIALING PROCEDURES

CHAPTER 9  PRIVILEGING: PROCEDURES FOR DETERMINATION OF CLINICAL
 PRIVILEGES

CHAPTER 10  BYLAWS AS A FOUNDATION FOR PEER REVIEW

PART II  PEER REVIEW

CHAPTER 11  INTRODUCTION TO PEER REVIEW

CHAPTER 12  CATEGORIZING CONCERNS THAT CAN BE ADDRESSED BY PEER
 REVIEW

CHAPTER 13  PROCESS FOR INITIATING AN INVESTIGATION

CHAPTER 14  USE OF INFORMAL RESOLUTION IN PEER REVIEW

CHAPTER 15  PRECAUTIONARY SUSPENSION OF PHYSICIAN PRIVILEGES

CHAPTER 16  AUTOMATIC RELINQUISHMENT OF CLINICAL PRIVILEGES

CHAPTER 17  INJUNCTIONS CHALLENGING PEER REVIEW ACTIONS

CHAPTER 18  SPECIAL CONSIDERATIONS FOR THE PEER REVIEW OF EMPLOYED
 PHYSICIANS

CHAPTER 19  USING A PATIENT SAFETY ORGANIZATION TO PROTECT PEER
 REVIEW INFORMATION

CHAPTER 20  ALLIED HEALTH PROFESSIONALS

CHAPTER 21  HIPAA PRIVACY RULE CONSIDERATIONS

PART III  PEER REVIEW HEARING

CHAPTER 22  INTRODUCTION AND OVERVIEW OF APPLICABLE LAW

CHAPTER 23  BYLAWS PROVIDING A FOUNDATION FOR A SUCCESSFUL HEARING

CHAPTER 24  WHEN IS A HEARING REQUIRED?

CHAPTER 25  NOTICE TO PRACTITIONER

CHAPTER 26  ROLE OF LEGAL COUNSEL

CHAPTER 27  USE OF HEARING OFFICER

CHAPTER 28  SELECTION OF HEARING COMMITTEE MEMBERS, ARBITRATOR, OR
 HEARING OFFICER

CHAPTER 29  PRE-HEARING PROCEDURES, INCLUDING DISCOVERY

CHAPTER 30  BURDEN OF PROOF AND EVIDENTIARY STANDARDS

CHAPTER 31  MAKING A HEARING RECORD

CHAPTER 32  CONDUCT OF HEARING

CHAPTER 33  HEARING COMMITTEE DECISION AND REPORT

CHAPTER 34  PROCEEDINGS AFTER HEARING COMMITTEE REPORT

APPENDIX A — HCQIA CASES
APPENDIX B — KEYSTONES OF A PEER REVIEW INVESTIGATION
APPENDIX C — SAMPLE FAIR HEARING AND APPELLATE REVIEW PLAN
APPENDIX D — SAMPLE INVESTIGATION REPORT
APPENDIX E — LETTER TO PRACTITIONER REGARDING ADVERSE
 RECOMMENDATION AND RIGHT TO HEARING
APPENDIX F — LETTER TO PRACTITIONER REGARDING HEARING DATE AND
 HEARING RIGHTS
APPENDIX G — HEARING OFFICER CHECKLIST
APPENDIX H — OUTLINE FOR HEARING COMMITTEE REPORT
APPENDIX I — SAMPLE INDEX FOR MEDICAL STAFF HEARING EXHIBIT BOOK APPENDIX J—SAMPLE APPLICATION MATERIALS

INDEX