Effective peer review is critical to health care providers’ efforts to continually improve patient safety and quality of care. Fair peer review hearings for physicians and other licensed health care practitioners are indispensable to effective peer review. Peer review hearings often are presided over by Hearing Officers. These Hearing Officers rule on procedural and evidentiary matters, but do not weigh evidence or make final decisions as do judges in jury trials.
SELA can provide attorneys who have extensive expertise in hospital law to serve as hearing officers under the medical staff bylaws in order to fulfil the Health Care Quality Improvement Act (“HCQIA”) mandate that panel members not be in economic competition with the affected physician. Because this process may result in disciplinary action, including denial of appointment or reappointment to staff, summary suspension, practice restrictions, or termination of a physician’s hospital privileges, a “fair hearing” is required.
“Fair Hearing” shall mean the hearing to which a physician or licensed health carepractitioner (as those terms are defined respectively in HCQIA), 42 U.S.C. § 11151(6) and (8)) is entitled under applicable Federal and/or State law or is otherwise related to a professional review action (as that term is defined in 42 U.S.C. § 11151(9)) taken against him or her. Without strict compliance with HCQIA and the medical bylaws, hospitals are at risk for significant adverse judgments.