Clinical Adverse Actions for Military Healthcare Providers

Placed in a Summary Suspension?

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Korody Law has handled countless clinical adverse actions for members of the Army, Navy, and Air Force medical corps and contractors and civil service healthcare providers at military treatment facilities.  Our goal is to protect the provider's privileges, reputation, and license.

As of October 1, 2019, all clinical adverse actions - from suspension through reporting - will be governed by the Defense Health Agency Procedures Manual, “Clinical Quality Management in the Military Health System,” Volumes 1-7.  This will replace the military-specific regulations currently in effect.

A military healthcare provider has due process!  Exercise those rights to the fullest.

The Defense Health Agency is assuming control over all military hospitals and clinics - first CONUS in 2019 and OCONUS in 2020 (planned).  Currently, with the exception of a few military treatment facilities (like Walter Reid National Military Medical Center in Bethesda and Fort Belvoir Community Hospital in Virginia), military hospitals and clinics are operated by the independent services.  The consolidation under the Defense Health Agency (DHA) is aimed at cost cutting and standardization (as with all military endeavors whether this saves resources or adds another layer of bureaucracy is to be seen!)   

However, with the release of Defense Health Agency Procedures Manual,“Clinical Quality Management in the Military Health System,” Volumes 1-7, there will be, for the first time, standardization for all military healthcare providers that find himself or herself under investigation for a quality assurance issue and in the clinical adverse privileging action process.  Previously, DODM 6025.13 set the floor for due process procedures for military healthcare providers with allegations of clinical incompetence, impairment, or other actions that called into question the ability to render safe and competent patient care.  Each service - Army, Navy, and Air Force - had their own instructions that further detailed the due process procedures.  As I have stated before, the Navy instruction issued by the Navy Bureau of Medicine was by far the most friendly to providers, providing extra-levels of due process and participation in the quality assurance investigation.

What are the rights now for a provider under investigation?

The process for all privileged providers - active, reserve, contractor, civil service - is provided in Volume 3 of DH-PM 6025.13.  As discussed in this DHA implementation memo, these procedures take effect for all actions initiated after October 1, 2019.

DHA-PM 6025.13 Volume 3 is a substantial overhaul of the adverse clinical action process.  These changes lessened the due process to the provider under review.  First, there is no longer an "abeyance" period at the outset of an investigation.  Providers will be placed in a summary suspension, which is reportable to states licensing agencies and the National Practicioners Data Bank after 30 days.  Previously, the abeyance period preceded the summary suspension and permitted the provider to avoid any reportable action if the matter was quickly resolved in the provider's favor.  For example, if the provider was cleared before a summary suspension was issued, the provider could answer "no" on privileging applications that asked if the provider "had ever had his/her privileges suspended."  A second change was the merging of the peer review panel with the hearing panel.  There is now a "peer review hearing" which appears to be a hybrid of both the peer review panel and the hearing panel.   This change means there is one less review of the allegations by a neutral panel. 

Why is this happening to me!

Even if you believe you did nothing wrong to be placed in a summary suspension, you should be prepared to defend yourself.  The new process in DHA-PM 6025.13 Volume 3 will make it easier for a privileging authority to deny, suspend, revoke, or reduce privileges.

Korody Law has successfully defended Navy, Army, and Air Force medical providers facing clinical adverse actions.  We have protected our clients' hospital privileges and medical licenses.  We have won countless hearings and appeals on behalf of clients. 

Placed in a Summary Suspension?

Free Consultation!
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