AHLA Peer Review Hearing Guidebook (Non-Members)

Since its inception the Peer Review Hearing Guidebook has become a popular go-to source for counsel, Hearing Officers and other parties with a stake in the review process.

by S. Allan Adelman (Author), Ann O'Connell (Author), American Health Lawyers Association (AHLA) (Author)

Publisher: AHLA

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ISBN: 9781422489727

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ISBN: 9780769887678

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Since its inception the Peer Review Hearing Guidebook has become a popular go-to source for counsel, Hearing Officers and other parties with a stake in the review process. This edition covers:

Joint Commission Standards, particularly MS.01.01.01 medical staff bylaw requirements
Case citations
Whether physicians employed or contracted with the hospital should serve on hearing panels
The right of practitioners to be represented by legal counsel during investigations
Collaborative processes for selecting hearing panel members
Bylaw provisions limiting the duration of hearings
Use of electronic medical records in hearings

Comprehensive coverage includes:

Fifty state survey
An introduction to the applicable laws, including the federal Health Care Quality Improvement Act of 1986 (HCQIA)
A step-by-step road map for hearing implementation of a successful peer review hearing process
The need for proper preparation and the important role of Medical Staff Bylaws
Who is entitled to a hearing
What effect does summary action by the entity have on the process
The role of the hearing officer; using an attorney as a hearing officer
Selection and role of the hearing committee
Pre-hearing discovery; various evidentiary standards of proof
The importance of a hearing record
Preparation of the final report for the Governing Committee

Step-by-step Guidance and Practical Tools

This indispensable Guidebook discusses not only the legal issues involved in peer review hearings, but also on the practical steps that can be taken to improve the peer review and hearing processes. Practice aids include:

A Fair Hearing and Appellate Review Plan
An investigation report
Letters to the affected practitioners
A Hearing Officer checklist

Sample documents are contained on a CD-ROM for easy customization.

The eBook versions of this title feature links to Lexis Advance for further legal research options.

Published August 2013.

Authors / Contributors

S. Allan Adelman

Ann O'Connell

American Health Lawyers Association (AHLA)

S. Allan Adelman

S. Allan Adelman, Esquire, (Co-Editor/Author) is a founding member of the firm of Adelman, Sheff & Smith, LLC in Annapolis, Maryland. He has been engaged exclusively in the practice of hospital and healthcare law, including the defense of medical malpractice cases, for over 30 years. Mr. Adelman is a past chair of the AHLA Credentialing and Peer Review Practice Group, was a member of the AHLA Board of Directors from 1997 to 2007, and served as President of AHLA in 2005-2006.

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Ann O'Connell

Ann O'Connell, Esquire, (Co-Editor/Author) is a partner in the Sacramento office of Nossaman Guthner Knox Elliott, LLP. She is past chair of the American Health Lawyers Medical Staff Credentialing and Peer Review Practice Group, and is past President of the California Society of Healthcare Attorneys. Her 30 years of health law experience encompass medical staff bylaws, rules and regulations, credentialing of physicians, and peer review and disciplinary proceedings.

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American Health Lawyers Association (AHLA)

As the nation’s largest, nonpartisan, nonprofit organization devoted to legal issues in the health care field, the American Health Lawyers Association (AHLA) leads in providing just-in-time education, establishing trusted resources, and encouraging robust dialogue among its members and the greater health law community. With nearly 14,000 members, AHLA boasts deep expertise among practitioners who represent clients across the entire health care industry spectrum. As a result, AHLA resources benefit not only attorneys, but also anyone who advises physicians, hospitals, health systems, specialty providers, payers, life sciences companies, and many other health care stakeholders. If you have an interest in health law, you have a home in AHLA. For more information about the education and resources of AHLA, please visit us at www.healthlawyers.org.

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 Preface 

 About the Authors

 Acknowledgments

 1   Introduction and Overview of Applicable Law 

 2   Bylaws Providing a Foundation for a Successful Hearing

 3   Peer Review Investigations

 4   When Is a Hearing Required? 

 5   Notice to Practitioner

 6   Role of Legal Counsel

 7   Use of Hearing Officer

 8   Composition and Selection of Hearing Committee

 9   Pre-Hearing Procedures--Discovery

 10   Burden of Proof and Evidentiary Standards

 11   Making a Hearing Record

 12   Conduct of Hearing

 13   Hearing Committee Decision and Report

 14   Proceedings after Hearing Committee Report

 15   Immunity for Participation and Decisions in the Peer Review Process

 Appendices

 Index

AHLA Peer Review Hearing Guidebook (Non-Members)

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Authors / Contributors

S. Allan Adelman

Ann O'Connell

American Health Lawyers Association (AHLA)

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