Skip to main content
Top Button

Licensing, Medical Staff Appointment, Credentialing and Privileging

Licensing

Your license to practice is the foundation of your professional career and livelihood. When allegations are made or formal charges are brought against a licensee, it is important to take the allegations seriously, defend against them aggressively and grow professionally. Ice Miller is experienced in assisting individual health care professionals seeking a license to practice, maintaining a license, defending against formal charges and addressing the collateral consequences of a licensing action.

Medical Staff Appointment, Credentialing and Privileging

Consolidation continues throughout the health care industry and the use of new technologies to deliver care through telehealth and telemedicine grows. In order to provide services to patients in-person or through technology in hospitals and surgery centers, physicians, surgeons and advance practice practitioners must seek and obtain membership appointment and/or clinical privileges. Medical staff offices and leaders of health systems, hospitals and surgery centers face significant pressures to expedite the evaluation of these applicant’s qualifications and credentials so these professionals can provide and bill for services sooner. Quality patient care is the goal of credentialing, privileging and other peer review activities. Therefore, this expediency has to be balanced with the paramount goal of safe quality patient care. Medical staff activities and responsibilities are designed to foster safe patient care. Medical staff bylaws, regulations and policies that govern the relationship between the medical staff members and the hospital can be outdated and not reflect the realities of today’s health care delivery systems. The medical staff is required to adapt to these new realities. Ice Miller is here to help.
 

Representative Experience

  • Represented licensed professionals and entities before licensing boards such as the medical licensing board, pharmacy board, physician assistant committee, veterinary board, nursing board and mental health professional board 
  • Represented licensed professionals and entities responding to consumer complaints and investigations by the Office of the Attorney General
  • Represented licensees in summary suspension proceedings before their respective boards
  • Represented registrants against allegations related to their controlled substance registration (CSR) and federal drug enforcement agency registration (DEA)
  • Peer review program design and structure
  • Represented and defended peer review determinations and activities in state and federal court
  • Assisted hospitals and health care entities with federal and state reporting obligations such as the National Practitioner Data Bank (NPDB) under the Health Care Quality Improvement Act, required reporting under licensing laws and Medicare regulations and the Emergency Medical Treatment and Active Labor Act (EMTALA)
  • Defended NPDB report challenged by physician
  • Represented medical executive committees and physicians in all phases of peer review activities including the investigation, corrective action, fair hearing and appeal proceeding at private and public hospitals and surgery centers and before payor and insurance panels
  • Assisted medical executive committees with addressing issues of professional conduct, competency and evaluation of patient care
  • Assisted medical staff officers address disruptive behavior, impairment concerns and other conduct that undermines the culture of safety
  • Developed policies to address electronic medical records, documentation, remote access and HIPAA privacy and security breaches, scribe usage and computer provider order entry (CPOE)
  • Developed fair hearing process for advanced nurse practitioners, physician assistants and other advance practice providers
  • Developed medical staff policies for new technology, telemedicine and telehealth and disaster privileges
  • Developed, reviewed and revised medical staff bylaws and other policies affecting the medical staff
  • Provided hearing officer services

Professionals

Name Position Phone Email
Kris M. Dawley Partner 614-462-2290
Sherry A. Fabina-Abney Partner 317-236-2446
Margaret R. Emmert Of Counsel 317-236-2169
View Full Site View Mobile Optimized