VA CREDENTIALING AND PRIVILEGING LAWYER
WORLDWIDE REPRESENTATION OF VA DOCTORS AND PROVIDERS FACING ADVERSE PRIVILEGING ACTIONS
In addition to being licensed by a state, Veterans Administrative (VA) Health Care System doctors, dentists, and other health care providers employed at VA hospitals and clinics must maintain “privileges” with the privileging authority. Generally, authority to grant, suspend, and revoke privileges rests with the Facility Director.
When VA Doctors are sick in a legal sense, they call Korody Law.
If allegations are made that the provider engaged in misconduct, suffers from professional incompetence, or is impaired, the privileging authority must determine whether or not a full investigation is warranted. The rules favor a full investigation following any allegation of misconduct, incompetence, or impairment that is not determined to be baseless through preliminary inquiries. During the investigation, a privileging authority will normally summarily suspend some or all of the provider’s privileges, meaning that he or she is commonly not permitted to treat patients. A written notice that a provider’s privileges have been summarily suspended is normally the first notice given to the provider that his or her privileges are at risk of being suspended, restricted, or revoked. Such action is commonly referred to as an Adverse Privileging Action.
During an investigation, the provider will normally be interviewed by the investigator.
It’s important to note that statements made during the investigation for the purposes of credentialing and privileging may be used at further reviews or hearings regarding the provider’s privileges.
A provider may also be clinically evaluated to determine the existence or extent of any alleged impairment. This may entail supervised practice in a case alleging professional impairment or substance abuse treatment in a case involving substance abuse.
It is in a provider’s best interest to consult with an attorney at the earliest possible time when facing a suspension and loss of privileges.
Once an investigation is complete, the privileging authority, with a recommendation from the Professional Standards Board or Medical Executive Committee, will decide whether to reinstate privileges or to restrict or revoke privileges. The provider can normally submit written matters to the Facility Director. If the Facility Director proposes taking adverse action against a provider, the provider will be notified of the right to a VA Review Panel Hearing and the right to appeal.
A medical provider should never waive the opportunity to appear before a Review Panel Hearing.
A Review Panel Hearing is an adversarial administrative hearing. A Recorder, normally a lawyer, will present the evidence of alleged misconduct, incompetence, and/or impairment through witnesses, exhibits, and documents. Similar to trial, the provider will have the opportunity to cross-examine witnesses, challenge evidence, and present a case in defense or extenuation or mitigation. Both sides will have the opportunity to argue to the panel, which is supposed to be composed of at least 3 privileged providers who are fair and impartial. The panel will determine if the allegations are true and, if true, make a recommendation to the privileging authority regarding reinstatement, revocation, or continued suspension. The provider can and SHOULD BE represented by an experienced and skilled attorney at the VA Review Panel Hearing.
An Adverse Privileging Action can have a severe consequences on a career and the ability to practice medicine inside and outside the VA Health Care System.
Adverse privileging actions are reported to the National Practitioner Data Bank (NPDB) and State Licensing Boards.
No suspension or investigation should be taken lightly; providers should begin mounting a defense the moment they receive notice that an allegation has been made. Most importantly, the provider should avoid making the situation worse, which is why it’s advisable to retain counsel as soon as possible.