Staff Privilege and Licensing Matters

Staff Privilege And Licensing Matters Overview

As a result of their extensive experience in the field of healthcare law, the attorneys at The Health Law Partners, P.C. have a thorough understanding of the issues most relevant to healthcare providers. This knowledge is particularly useful in addressing the myriad of issues, both conspicuous and inconspicuous, that arise during staff privilege and licensing matters. Such experience and knowledge allow the attorneys at The Health Law Partners, P.C. to provide the appropriate assistance and guidance to their clients at each step in the process with the goal of resolving their matters successfully and as efficiently as possible. When faced with a potential staff privilege or licensing matter, it is crucial for the healthcare provider to understand the importance of immediately contacting an experienced healthcare attorney (i.e., one who understands the procedures and processes involved in such matters, as well as the serious collateral effects and ramifications that such matters may have upon one’s professional career) as early as possible in order to take advantage of any available opportunities for early resolution prior to the initiation of formal proceedings and/or to mitigate against the imposition of severe disciplinary action. Early intervention by the attorneys at The Health Law Partners, P.C. may significantly increase the likelihood of success in such matters and avoid the time and emotional and financial costs often associated with addressing such matters at later stages. Nonetheless, in the event that there is no reasonable opportunity to resolve the matter short of a hearing and/or litigation, healthcare providers should be assured that the attorneys at The Health Law Partners, P.C. have the drive, experience, knowledge and skills necessary to advocate the interests of, and represent, their clients to the fullest extent possible in all available stages.

Staff Privilege Matters

Staff privilege matters are typically governed by the Medical Staff Bylaws of the hospital involved. The Medical Staff Bylaws may incorporate other documents such as a Fair Hearing Plan or Rules and Regulations depending on the particular hospital. In some jurisdictions, Medical Staff Bylaws are considered to be contracts with which both the hospital and healthcare provider must comply. However, in other jurisdictions, Medical Staff Bylaws are not considered to be contracts, and while the healthcare provider is required to adhere to its terms, the hospital is not. When healthcare providers are not fully aware of their rights, responsibilities and obligations contained within the Medical Staff Bylaws, what may begin as an innocuous allegation (e.g., via an informal meeting with a hospital administrator) can quickly progress into a formal matter culminating in a so-called “fair hearing”—which is often, in the eyes of many healthcare providers, lacking in the essential elements of due process. Once a fair hearing begins, the healthcare provider often finds himself/herself in an inferior position due to the hospital’s control over this internal appeals process. Accordingly, providers are rarely triumphant in fair hearings. Despite such odds, the attorneys at The Health Law Partners, P.C. have enjoyed great success on behalf of their clients by paying meticulous detail to the policies and procedures set forth in Medical Staff Bylaws and by fighting for their clients’ rights at every step of the process. The attorneys at The Health Law Partners, P.C. are also cognizant of the collateral effects that an adverse action against a physician’s staff privileges may have (e.g., a report to the National Practitioner Data Bank or to the applicable State licensing board) and take such ramifications into consideration when attempting to resolve the staff privilege matter. By contacting The Health Law Partners, P.C. at the earliest recognizable stage of a potential staff privilege matter, the healthcare provider may be able to avoid the progression of a minor issue into a major case with devastating results.

Licensing Matters

Unfortunately, some healthcare providers fail to appreciate the serious magnitude of an allegation filed against them with their state licensing body. Whether a healthcare provider is contacted directly by an investigator or whether he or she hears from a patient or an employee that an investigator has been asking questions regarding the professional behavior/conduct of the healthcare provider, the healthcare provider should immediately contact an experienced and knowledgeable healthcare attorney to provide assistance and guidance at the earliest possible stage. All too often, healthcare providers believe that they can explain away or justify the alleged inappropriate behavior/conduct only to learn later on that such admissions are used as direct evidence against them to support a sanction against his or her healthcare license. Moreover, depending on the severity of the sanction imposed, there are numerous collateral effects that a state licensing action may have on the healthcare provider, including, but not limited to:

  • Loss of hospital privileges and/or employment;
  • Loss of enrollment with state professional associations and their associated benefits (e.g., health, disability and life insurance);
  • Loss of participation in Preferred Provider Organizations (PPOs) and other third party payors;
  • Loss of Drug Enforcement Administration (DEA) registration, state controlled substance licenses and other healthcare licenses/registrations;
  • Loss of board certification;
  • Exclusion from participation with Medicare, Medicaid and other federal and state governmental programs;
  • Commencement of other judicial or administrative proceedings (e.g., criminal proceedings, civil monetary proceedings, malpractice actions, and other state licensing actions); and
  • Permanent reports to the National Practitioner Data Bank and state licensing data banks.

Prior to the commencement of a formal hearing, there is often a window of opportunity in which an experienced and knowledgeable healthcare attorney can help the physician to develop and implement prophylactic measures and to take certain actions that may convince the licensing authorities not to proceed with disciplinary action or to accept a sanction less severe than originally recommended. Due to this relatively small time frame, it is imperative that the healthcare provider contact an attorney at the earliest recognizable stage of a potential licensing matter. As Benjamin Franklin once said: “an ounce of prevention is worth a pound of cure”—a healthcare provider that retains an experienced and knowledgeable healthcare attorney early in the process can often avoid the increased time and financial resources involved in trying to win a licensure case at an administrative hearing, when compared to resources needed to implement reasonable measures to rectify the alleged inappropriate behavior/conduct.

Publications


"State of Michigan Health Care License Investigations and the Collateral Effects of Licensing Sanctions", by Robert S. Iwrey, Esq., was the featured article in Laches Oakland County Bar Association, February 2013 edition.

Robert S. Iwrey, Esq. co-authored "State of Michigan Health Care License Investigations and The Collateral Effects of Licensing Sanctions", State Bar of Michigan, Health Care Law Section, January, 2013.

"Practical Tips to Avoid Licensing Action", by Robert S. Iwrey, Esq., Michigan Medical Law Report, Fall 2012.

"Michigan LARA Creates New Health Care Services Bureau", by Robert S. Iwrey, Esq., October 19, 2012.

"What to Do When Faced With a Staff Privilege or Licensing Matter," by Robert S. Iwrey, Esq., Health Care Weekly Review, Vol. 26, Num. 11. April 1, 2010. p.5.

"Beware: Investigations and disciplinary actions may lead to charges," by Robert S. Iwrey, Esq. Michigan Medical Law Report, Vol. 6, No. 1, Spring 2010. p.1.

"State licensing investigations: An ounce of prevention..." by Robert S. Iwrey, Esq., Michigan Medical Law Report, Vol. 5, No. 4, Winter 2010.

"NPDB: 'I Hope You Know That This Will Go Down On Your Permanent Record'" by Robert S. Iwrey, Esq., Michigan Medical Law Report, Vol. 5, No. 3, Fall 2009.

"Healthcare Licensing Actions and Criminal Implications," by Robert S. Iwrey, Esq., Laches, September 2009

"Physician Disruptive Behavior Policies Require a Measured Approach," by Robert S. Iwrey, Esq., MedStaff News, September 2009

"New rules on disruptive behavior require a measured approach," co-authored: Robert S. Iwrey, Esq., Michigan Medical Law Report, Vol. 5, No. 1, Spring 2009

Presentations

“Collateral Consequences of Criminal Convictions: The Civil Penalties Most Likely to Affect Michigan Criminal Defendants,” the professional licensing portion of the seminar to be presented by Roberts S. Iwrey, Esq., Institute for Continuing Legal Education Criminal Defense Series, June 27, 2012, Ann Arbor, MI.

"Increased Governmental Scrutiny on Michigan Health Care Providers and How to Avoid Becoming a Target" by Robert S. Iwrey, Esq. at The Medial Wealth Center Practice Prosperity Series, March 30, 2010.

"Interaction of physician licensing and discipline and criminal investigations and prosecutions" (Co-Presentation by Robert S. Iwrey, Esq. with Michigan Assistant Attorney General), Oakland County Bar Association - Oakland County Medical Society, May 12, 2009 and May 14, 2008. See also the video on the HLP TV Page entitled "Licensing Actions."

"Medical Staff, Peer Review and the Effects of Feyz One Year Later" Co-presentation by Robert S. Iwrey, Esq. to other health care lawyers at the annual meeting of the State Bar of Michigan - Health Care Law Section, September 19, 2007

Staff Privilege And Licensing Questions?

Since 1999, Robert S. Iwrey, Esq. has successfully represented physicians and other healthcare providers in staff privilege and licensing matters. He is able to provide guidance and assistance to providers throughout all stages of the staff privilege and licensing processes. Mr. Iwrey is fully cognizant of the spiraling consequences that these types of actions can have on a healthcare provider’s career and can offer a global perspective of the collateral effects when trying to resolve such matters. Staff Privilege and Licensing inquiries can be directed to Mr. Iwrey at (248) 996-8510 or (212) 734-0128.