The Law Offices of Jeffrey C. Grass has been defending physicians' hospital privileges around the country for the past 20 years. We have a national practice in preserving the most important asset a physician has besides their professional license — their hospital clinical privileges. Frequently, a physician's medical staff privileges will come under attack by economic competitors or political adversaries through false allegations of poor patient care or disruptive behavior. This is called "Sham Peer Review." The Law Offices of Jeffrey C. Grass has been defending physicians for almost 20 years against such allegations and has been recognized by the Semmelweis Society for its efforts in 2009 when they awarded Jeffrey C. Grass their "Clean Hands Award." You may also see on this site several briefs to the Court of Appeals and the United States Supreme Court that Jeffrey C. Grass has written in an effort to change the law which is so devastating to a medical professional's career.
A physician's due process rights in the face of a Professional Review Action are established by the 1986 HealthCare Quality Improvement Act (HCQIA) and in the states' Medical Practice Act and are reflected in the hospital's Medical Staff Bylaws. A physician must immediately take precautions and avail themselves of the rights afforded them under the Fair Hearing Procedures of the Bylaws in the face of a complaint of quality of care or a focused review of their patient's charts.
A Professional Review Action as defined by the HealthCare Quality Improvement Act (HCQIA) of 1986, 42 U.S.C. §§ 11101-11152 (HCQIA), is an adverse action or adverse recommendation that negatively affects the privileges or membership of a physician or dentist for a period of greater than thirty (30) days. These actions or recommendations can be the summary suspension of privileges, modification of clinical privileges, restriction of clinical privileges, and a limitation or revocation of clinical privileges. The new weapon in the arson for hospitals to attack individual physicians through "sham peer review" is the so called "disruptive physician." It is now found in all Medical Staff Bylaws and usually crops up individually in the confidential settings of medical staff committees, and is often based on nebulous "psychological" or alleged personality issues. Notably, the hospital bar is now featuring a seminar for medical staffs in promoting their definition of "Disruptive Behavior" in hospitals. The original definition of "Disruptive Conduct" was set forth by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the American Medical Association (AMA). However, the definition promoted by the hospital bar is purposely broad, general, vague, subjective, and essentially undefined so as to allow hospital administrators to interpret it however they wish. This development in "Sham Peer Review" has led to widespread abuse of the "Disruptive Physician" label in hospitals. The careers of many good, highly trained, ethical physicians have been ruined and patients have been deprived of quality care as a result.
Professional review actions are reportable to the National Practitioner Data Bank (NPDB); it is one of the federal data banks that has been created to serve as a repository of information about health care providers in the United States. Federal law requires that adverse actions taken against a health care professional's license be reported to this data bank. Being reported to the NPDB can result in the loss of hospital privileges entirely. It can also result in the removal of a provider from private insurance rolls and a loss of eligibility to participate in Medicare, Medicaid and any Federal Health Care program. Similarly, such a report can result in a complaint to a health care practitioner's state licensing board and the loss of or restriction of a professional license or a removal from eligibility for board certification.
Contact a Hospital Clinical Privileges Attorney
For more information about medical peer review defense, please contact a lawyer to arrange an initial consultation.
We offer free initial consultations to prospective clients throughout the country. Based in our offices in Dallas and Plano, Texas, we regularly travel around the country to meet with clients. If you choose to retain us, we offer cost-effective service and accept credit cards for payment.
