Protecting Your Rights Against Sham Peer Review

Sham Peer Review Defense

The cornerstone of the defense of a physician under medical peer review will be to challenge the hospital’s conformance to the requirements of the Health Care Quality Improvement Act of 1986 (HCQIA) and the institution’s bylaws. It is imperative to begin to build an effective defense as soon as possible given the short timeframes for requesting a fair hearing, obtaining and reviewing relevant medical records and documentary evidence and obtaining expert witness support.

A checklist of critical information to compile as soon as possible in any potential physician peer review case includes the following:

1. 1. 1. Your C.V.
      2. Any documents related to prior peer review or disciplinary matters
      3. Any communications, including emails and/or text messages, with hospital administration or fellow staff members
      4. A timeline of events leading to the incident(s) resulting in sham peer review
      5. A list of any prior criminal convictions, licensing sanctions or investigations and professional liability claims

If you are confronted with a challenge to your hospital staff privileges or by a potential adverse hospital credentialing matter, contact Aaron Kemp, Senior Attorney and Chairperson of the Professional Licensing & Regulatory Affairs Group at Chapman Law Group, for representation.