Since the early 1990s, hospitals have been required to report certain adverse actions taken against physicians to the National Practitioner Data Bank. Also, hospitals must file a National Practitioner Data Bank report on any physician’s surrender of privileges if an investigation is underway, when no action has been taken by the hospital medical staff. This has always been a Data Bank reporting requirement, intended to discourage plea bargains which allowed physicians to avoid being reported if they agreed to waive hearing rights. Under changes made to the Data Bank Guidebook in 2015 and again in 2018, expanded descriptions of “investigation” and “surrender” stretch what is to be considered a reportable surrender of privileges. OPPE and FPPE and other peer review can be affected, as are physicians’ ability to make practice decisions without inadvertently tripping Data Bank reporting triggers. Medical staff bylaws and policies need to be reworked under the new Data Bank Guidebook.
- To be aware of National Practitioner Data Bank Guidebook revisions.
- To know what new government interpretations of the regulatory scheme are included
- To know most medical staff policies and bylaws in hospitals today do not prevail.
- To provide legal protections for medical staff leaders and hospitals
- To make credentialing staff familiar with the changes.
- Physicians will be surprised by reports generated under the new Guidebook.
- Any interruption in a physician’s practice, including leaves of absence, may trigger reporting if an investigation is underway.
Areas Covered in the Session:
- National Practitioner Data Bank Guidebook changes
- Hospital reporting requirements
- Medical staff bylaws problems
- Peer review process issues
- Physician credentialing
- Medical Staff Leaders
- Hospital Executives
- Credentialing Specialists
- Medical Staff Managers
- Chief Medical Officers
- Vice President of Medical Affairs
- Health Lawyers
About the Presenter:
Elizabeth Snelson, Esq. works with medical staffs across the country, focusing on medical staff bylaws and credentialing, and works for medical societies on medical staff compliance and other issues. A frequent speaker on medical staff legal issues, Ms. Snelson presents at medical staff leadership retreats and other programs sponsored by medical staff services associations and medical societies and provides expert testimony on peer review and related matters. She is Past President of the American Society of Medical Association Counsel and past Vice President of the ABA’s Physician Issues Interest Group. She was a member of the Joint Commission’s MS 01.01.01 Task Force. Her articles on medical staff legal issues have appeared in various publications. She is the author of The Physicians’ Guide to Medical Staff Organization Bylaws, published by AMA.
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