Hospital-Physician Relations and Medico-Legal

Experience

• Participate in review of, and revisions to, medical staff bylaws, rules and regulations, and policies such as Codes of Conduct and Disruptive Behavior for more than 200 hospitals in Chicago and around the country including academic medical centers, and suburban and critical access hospitals.
• Involvement in over 200 peer review hearings and thousands of peer review issues and investigations for hospitals in Illinois and several out-of-state hospitals.
• Successful defense of hospitals and medical staffs in more than 100 state and federal credentialing lawsuits.
• Assistance to health care systems in consolidating medical staffs subsequent to a merger and revision of leadership structure and bylaws.
• Mediator and consultant in disputes between hospital and medical staff, including physician groups.
• Advise health care clients on a range of hospital-physician relations issues. Includes physician employment and recruitment, physician compensation, exclusive contracts, medical staff development plans, hospital licensure and accreditation, emergency department coverage and compensation arrangements, medical staff bylaws, peer review, hospital/medical staff disputes, ACO privileging and credentialing, allied health professionals, medical staff mergers and integration, and Data Bank and state disciplinary reporting
• Special counsel to state Hospital Association on various statutory initiatives affecting hospital/physician relations in areas of employment, exclusive contracts, restrictive covenants, medical staff credentialing, the Hospital Licensing Act and Medical Studies Act.
• Assistance to PSOs and their participating providers with respect to certification and recertification by Agency for Healthcare Research & Quality (AHRQ) and compliance with Patient Safety and Quality Improvement Act of 2005.
• Represent health care providers and PSOs in major state appellate and supreme court decisions, including US Supreme Court, involving interpretation of privilege provisions under Patient Safety Act as applied to PSOs and providers.
• Represent hospitals in accreditation investigations and hearings.
• Appointment as hearing officer in fair hearing proceedings.
• Develop information-sharing policy allowing multi-hospital systems to share confidential peer review information in compliance with state law.
• Counsel in connection with conducting audits of health care clients to review and evaluate sensitive quality assurance/performance improvement/peer review documents to take steps to maximize protection under state and federal confidentiality and privilege statutes.
• Represented clients in Centers for Medicare & Medicaid Services, state public health and Office of Inspector General complaints against hospitals alleging EMTALA violations.
• Represent hospitals and medical staffs in dealing with disruptive, aged and impaired physicians.
• Successfully represent hospitals in responding to Office for Civil Rights HIPAA complaints and investigations.
• Represent hospitals in accreditation hearings and disputes with The Joint Commission regarding preliminary denials of accreditation and other accreditation matters.