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.
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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.
Table of contents
PART I MEDICAL STAFF
CHAPTER 1 INTRODUCTION: HISTORICAL PERSPECTIVE ON THE MEDICAL
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
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
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
CHAPTER 19 USING A PATIENT SAFETY ORGANIZATION TO PROTECT PEER
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
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
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