DoD Adverse Action Process

1. DoD Adverse Action Process Privileged Providers April 2009

2. DoD Adverse Action Legal Risk to pt / staff safety Or service integrity Notice Immediate Action Req’d? Notice No Yes REMOVE (abeyance 30-d) Reinstate M&E-option Notice QA Investigation Inquiry Abeyance  Adverse Action

3. DoD Adverse Action Legal QA Investigation Inquiry complete Notice Provider reinstate CLOSE Consider M & E Yes No Notice Summary Suspension-6 mons CF REVIEW Next Pg Note: must request command approval to extend summary suspension every 6 mon interval

4. DoD Adverse Action Cred Comm review Forward to MTF/CC w/recom MDG/CC proposed action Provider RTD? No Notice Yes Heard Peer Review Panel Notice Next Pg Reinstate priv Consider M & E Provider may provide written comments to panel, but does not attend in person.

5. DoD Adverse Action Legal Forward w/recom to: Cred Comm Cred Comm Forwards rec to MTF/CC Peer Rev Panel complete Hearing MTF/CC Adv action Hearing Yes Yes Written notice 30-60 d to schedule 3-member (1 peer) No No Notice Reinstate Consider M & E Waive hearing— Waive appeal right Next pg

6. DoD Adverse Action Forward w/ findings & recom to: MTF/CC + Provider Legal Provider may submit Except/Correct Hearing Complete Record of Hearing 10-d Verbatim record NLT 30-d CC Decision Adv action 10-d Yes CC may make alternate decision, must provide written rationale Notice Heard No APPEAL To SG via MTF/CC 10-d Reinstate Consider M & E Notice Next Pg

7. DoD Adverse Action Recommendation to SG Appeal forwarded To SG Appeal review: Legal Clinical 10-d SG decision uphold Adv action Yes SG may make alternate decision, will provide written rationale Notice No Report as directed 10-d Reinstate Consider M & E Notice Report to NPDB and States of known licensure