Posts tagged Hospitals and Health Facilities.
Colorado's Peer Review Privilege in Peril

The confidentiality of medical staff peer review has long been a cornerstone of hospital operations, fostering an environment where physicians can candidly evaluate medical care without the looming specter of malpractice exposure.  But this established norm is facing a new threat in Colorado, where a ballot proposal aims to gut peer review confidentiality.

The Foundation of Peer Review Confidentiality

Peer review is a process in which physician conduct that endangers patients within a hospital can be immediately reviewed by peers.  Peer review’s goal is to promote continuous ...

Peer Review Hearings Are Not Court Trials: California Reaffirms Flexible Nature of Fair Procedure

The California Supreme Court recently issued its decision in Boermeester v. Carry. Though the case deals with fair procedure within a private university’s internal disciplinary proceedings, it provides helpful guidance for peer review bodies navigating medical disciplinary hearings.

Boermeester reiterated the long-standing admonition that courts should not try to impose “rigid procedures” upon private organizations’ administrative proceedings. Rather, the organizations themselves should develop methods for providing the fundamentals of fair ...

Peer Review or Employment? A Framework for Addressing Physician Performance Issues in Hospitals

COVID-19 accelerated the trend of physician employment with hospitals, with recent data showing that nearly 70 percent of physicians are employed by hospitals or hospital-affiliated foundations or groups.  While physician integration improves quality of care and clinical efficiency, it also blurs the separation of responsibilities between the medical staff and the employer.  This can create headaches for stakeholders who want to address physician performance issues. … 

CMS Attempts to Reduce Appointment Times for Medicaid and CHIP Patients - How Will This Impact Your Managed Care Plan?

A recent survey found that the average wait time for a new patient to see a physician in 15 of the largest cities in the U.S. was 26 days, up from 24.1 days in 2017. Timely access to health care providers has long been an issue, but appears to be worsening in certain geographies and provider types. Until recently, timely access to care was regulated at the state level; however, in April, the Centers for Medicare & Medicaid Services (CMS) unveiled its proposed rule to address the issue. The Notice of Proposed Rulemaking Managed Care Access, Finance, and Quality (CMS-2439-P) (NPRM) only ...

A New Accreditation Standard and What It Means for Medical Staffs

It’s no secret that patients from marginalized groups experience lower quality health care.  Acknowledging its role in closing the health care disparity gap, the Joint Commission recently announced new and revised requirements to reduce health care disparities in accredited facilities.  For medical staffs, the new accreditation standard provides an opportunity to lead the fight against health care disparities.

Medical literature over the past twenty years confirms the persistence of health care disparities.  In August 2021, the Journal of the American Medical Association ...

Posted in COVID-19, HIPAA
Providers Permitted to Use Video Chat Applications During COVID-19 Pandemic

Recognizing the need to empower healthcare providers to reach those most at risk during the COVID-19 pandemic, the Department of Health and Human Services’ Office for Civil Rights recently issued a notification announcing that it will not impose penalties for noncompliance with HIPAA Rules against those healthcare entities who utilize video and voice applications to provide telehealth services.

During this national emergency, covered healthcare providers can use any non-public facing application to communicate with patients, such as Apple FaceTime, Facebook Messenger ...

Is It the End of Yaqub for Hearing Officer Selection?

For more than 15 years, the process of selecting a hearing officer for a medical staff peer review proceeding has been strongly influenced by the decision in Yaqub v. Salinas Valley Memorial Healthcare System 122 Cal. App. 4th 474 (2004). That decision held that a hearing officer in a peer review proceeding was disqualified for a financial bias based upon the hearing officer's “long–standing and continuous relationship" with the hospital, which created a “possible temptation" to favor the hospital.

The court disqualified the hearing officer despite the fact that “there ...

In a decision affecting California hospitals, medical groups, medical staffs, and physicians, the California First District Court of Appeal has concluded that a physician’s notice and hearing rights apply to situations where a hospital directs a medical group of a closed department to remove a physician from the hospital schedule.

In Economy v. Sutter East Bay Hospitals, Sutter Hospital operated a closed anesthesia department pursuant to a contract with East Bay Anesthesiology Medical Group (East Bay Group).  The exclusive contract required all physicians providing ...

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