QUESTION

How does an adverse decision from a hospital peer review affect me?

SHORT ANSWER
An adverse decision may be reported to the National Practitioner Data Bank and often impacts the physician’s ability to obtain privileges at other hospitals.
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Congress created the National Practitioner Data Bank (“NPDB”) to improve the quality of health care, protect the public, and reduce fraud and abuse. Hospitals are required to report professional review actions affecting clinical privileges for longer than 30 days to the NPDB. Further, hospitals must report the voluntary surrender or restriction of clinical privileges while under investigation, or to avoid an investigation. Because hospitals and state licensing boards query the NPDB whenever a physician applies for hospital privileges or a medical license, damaging information contained in a report follows the physician and often impacts the physician’s ability to obtain privileges at other hospitals. Accordingly, a medical peer review is a serious, potentially career-changing process that should be approached by a physician with great care and with the advice and counsel of experienced healthcare attorneys.

If you are a physician subject to peer review, or a facility initiating one, ASG Law can help you develop and implement an appropriate strategy.