Licensing and Staff Privilege Matters

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  • Drug Enforcement Administration (DEA) Registration Matters
  • Healthcare Professional Licensing Matters
  • Hospital and Ambulatory Surgical Center (ASC) Staff Privilege and Credentialing Matters
  • National Practitioner Data Bank and State Licensing Data Bank Matters

The Health Law Partners, P.C. has a thorough understanding of the issues most relevant to health care providers. This knowledge is particularly useful in addressing the myriad of issues, both conspicuous and inconspicuous, that arise during staff privilege and physician licensing matters and the serious collateral effects that can befall one’s professional career. Early intervention by the attorneys at The Health Law Partners, P.C. may significantly increase the likelihood of success in such matters and avoid the time and emotional and financial costs often associated with addressing such matters at later stages. Nonetheless, in the event that there is no reasonable opportunity to resolve the matter short of a hearing and/or litigation, health care providers should be assured that our attorneys have the drive, experience, knowledge and skills necessary to advocate the interests of, and represent, their clients to the fullest extent possible in all available stages.

Staff Privilege Matters

Staff privilege matters are typically governed by the Medical Staff Bylaws of the hospital involved. The Medical Staff Bylaws may incorporate other documents such as a Fair Hearing Plan or Rules and Regulations depending on the particular hospital. In some jurisdictions, Medical Staff Bylaws are considered to be contracts with which both the hospital and health care provider must comply. However, in other jurisdictions, Medical Staff Bylaws are not considered to be contracts, and while the health care provider is required to adhere to its terms, the hospital is not.

When health care providers are not fully aware of their rights, responsibilities and obligations contained within the Medical Staff Bylaws, what may begin as an innocuous allegation (e.g., via an informal meeting with a hospital administrator) can quickly progress into a formal matter culminating in a so-called “fair hearing”—which is often, in the eyes of many health care providers, lacking in the essential elements of due process. Once a fair hearing begins, the health care provider often finds himself/herself in an inferior position due to the hospital’s control over this internal appeals process. Accordingly, providers are rarely triumphant in fair hearings.

Despite such odds, the attorneys at The Health Law Partners, P.C. have enjoyed great success on behalf of their clients by paying meticulous detail to the policies and procedures set forth in Medical Staff Bylaws and by fighting for their clients’ rights at every step of the process. Our attorneys are also cognizant of the collateral effects that an adverse action against a physician’s staff privileges may have (e.g., a report to the National Practitioner Data Bank or to the applicable State licensing board) and take such ramifications into consideration when attempting to resolve the staff privilege matter. By contacting our firm at the earliest recognizable stage of a potential staff privilege matter, the health care provider may be able to avoid the progression of a minor issue into a major case with devastating results.

Licensing Matters

Unfortunately, some health care providers fail to appreciate the serious magnitude of an allegation filed against them with their State licensing body. All too often, health care providers believe that they can explain away or justify the alleged inappropriate behavior/conduct only to learn later on that such admissions are used as direct evidence against them to support a sanction against his or her health care license. Moreover, depending on the severity of the sanction imposed, there are numerous collateral effects that a state licensing action may have on the health care provider, including, but not limited to:

  • Loss of hospital privileges and/or employment;
  • Loss of enrollment with State professional associations and their associated benefits (e.g., health, disability and life insurance);
  • Loss of participation in Preferred Provider Organizations (PPOs) and other third party payors;
  • Loss of Federal Drug Enforcement Administration (DEA) registration, State controlled substance licenses and other health care licenses/registrations;
  • Loss of board certification;
  • Exclusion from participation with Medicare, Medicaid and other Federal and State governmental programs;
  • Commencement of other judicial or administrative proceedings (e.g., criminal proceedings, civil monetary proceedings, malpractice actions, and other State licensing actions); and
  • Permanent reports to the National Practitioner Data Bank and State licensing data banks.

Prior to the commencement of a formal hearing, there is often a window of opportunity in which an experienced and knowledgeable health care attorney well versed in physician licensing can help medical professionals develop and implement preventative measures, as well as to take certain actions that may convince the licensing authorities not to proceed with disciplinary action or to accept a sanction less severe than originally recommended. Due to this relatively small time frame, it is imperative that the health care provider contact an attorney at the earliest recognizable stage of a potential licensing matter.

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