Subject of a quality assurance investigation?

We defend military medical providers.

Army   Navy   Air Force

Uniformed, Civilians, Contractors

Worldwide

“The biggest mistake providers make is thinking they can talk their way to immediate reinstatement when notified of a summary suspension of privileges.  That ‘talking’ often is more harmful than helpful.”

– Attorney Patrick Korody

Attorney Patrick Korody spent 10 years on active duty as a Navy Judge Advocate.  He has invaluable experience defending military medical providers accused of professional and personal misconduct, clinical incompetence, or impairment while working at military treatment facilities (MTFs). 

Mr. Korody dedicates a significant portion of his practice to defending military doctors, nurses, and other providers facing adverse privileging actions by military authorities and the Defense Health Agency (DHA) Initiated Under DHA-PM 6025.13, Volume 3.

“Save your license.  Save your career.”

Worldwide Representation of Military Medical Providers

Consequences of an adverse privileging action.

Privileges will be denied, suspended, restricted, reduced or revoked.

Permission to engage in off-duty employment will be revoked.

Military members may be processed for separation.

Civilians and contractors may have employment terminated.

The action will be reported by the Defense Health Agency to the National Practitioner Data Bank (NPDB) and state licensing authorities.

Do Not Stand Alone.

Hiring Korody Law means that you have an advocate in your corner.

An experienced advocate who understands your rights.

A trained advocate who knows how to exercise those rights to protect your career and licenses.

The Process – DHA-PM 6025.13

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Allegation.

If allegations are made that the provider engaged in misconduct or is impaired or incompetent, the privileging authority must determine whether or not a full investigation is warranted. The rules favor a full investigation following any allegation of misconduct or impairment that is not determined to be baseless through preliminary inquiries.

Summary Suspension.

During the investigation, a privileging authority will normally place the provider’s privileges in summary suspension, meaning that he or she is commonly not permitted to practice medicine. A notice that a provider’s privileges are in summary suspension is normally the first notice given to the provider that his/her privileges are at risk of being suspended, reduced, or revoked.  As of October 1, 2019, when DHA-PM 6025.13 became effective and replaced the governing DoDI and service regulations, summary suspensions in effect for more than 30 days are reported to the National Practitioner’s Data Bank (NPDB).

Quality Assurance Investigation.

An investigating officer, normally a provider with similar experience and training, will be appointed to investigate the allegations.  The investigation is normally not limited to a specific case and may encompass a provider’s entire practice of medicine or a sampling of the provider’s entire practice.  The provider is no longer interviewed during the investigation but is given a redacted copy of the investigation to provide comments.

Comments by the Provider.

The investigation will be given to the provider to provide comments.  The investigation should include all enclosures and the provider should be given access to relevant medical records.

Review by Credentialing Board.

The investigation and provider comments will be reviewed by the MTF’s credentialing board (Credentialling Committee), who will normally make a recommendation to the MTF commander on what action to take against the provider.

Commander’s Initial Decision.

The MTF commander will review the investigation and recommendations and will direct reinstatement with or without monitoring and evaluation or propose an adverse clinical action (reduction, suspension, revocation).

Clinical Adverse Actions and Adverse Privileging Actions for military doctors, nurses, and other providers are governed by DHA-PM 6025.13 Volume 3 as of October 1, 2019.

Read our Post about DHA-PM 6025.13 Volume 3 and it’s impact on a provider’s rights.

The Hearing.

A provider’s primary due process right is an adversarial hearing before a panel of providers.  Witnesses will be called.  Evidence will be admitted.  The MTF is normally represented by a physician and legal advisor.  A majority of the hearing panel members must be peers of the provider under review.

Hearing Findings and Recommendations.

The panel deliberates and makes findings for each allegation and makes recommendations as to what, if any, adverse action should be taken against the provider.  The hearing panel can also recommend reinstatement or reinstatement with monitoring and evaluation.

Commander’s Final Action.

The MTF commander will review the hearing findings and recommendation and then take final action.

Appeal.

If an adverse action is taken, the provider has the right to a written appeal to the Report Authority.  The Report Authority depends is either Director of the DHA or the service’s senior medical commander if the provider is not privileged by a Privileging Authority falling under the DHA.

Final Action and Reporting.

If the adverse action is final, reports will be made to the NPDB and state licensing authorities.