NAMSS Conference – HCQIA Hearing Rights

I listened in recently to the National Association Medical Staff Services (NAMSS) Virtual Conference sessions.  Getting into the online program was easy, the sound was good, the slides were easy to see and follow, and no trips through airline security were required.  Overall I’d give the experience an A. 

Speakers for Thursday’s virtual sessions were Carol Cairns, CPMSM, CPCS, Sally Pelletier, CPMSM, CPCS, Linda Haddad, JD, and Todd Sagan, MD, JD., and every session was full of good instruction.  

One particular point worth noting was the reminder Dr. Sagan gave about hearing rights and HCQIA immunity.  We’re all keenly aware of the requirement to report any physician suspension of more than 30 days to the National Practitioner Data Bank (NPDB), but my ears perked up at his mention of the 14 day hearing requirement in order to qualify for protection from the Healthcare Quality Improvement Act (HCQIA).

The Healthcare Lawyers site provides the HCQIA language pertaining to hearings:

Notice of Hearing: If the physician timely requests a hearing, he must be given a notice stating:

1. the place, time and date of the hearing, which shall not be less than 30 days after the date of the notice…

Hearing Requirements: …

 The above notice and hearing procedures are not required in situations where no adverse professional review action was taken or if a physician’s clinical privileges are suspended or restricted for 14 days or less, during which time an investigation must be conducted to determine whether a professional review action is needed.  (see: 42 U.S.C. Section 11112(c)(1)).

At least for me, that was a lesser known requirement, and an excellent reminder.