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Summary suspension not greater than 15-day + optional 15-day extension in writing – 30 day total. Discovery Event Complaint Suspicion. Adverse Privileging Process Schematic. Abeyance. CQ Investigation. Report in writing findings and recommendations to

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slide1

Summary suspension not greater than 15-day + optional 15-day extension in writing – 30 day total.

Discovery

Event

Complaint

Suspicion

Adverse Privileging

Process Schematic

Abeyance

CQ Investigation

Report in writing findings and recommendations to

Credentials Committee – reviews report + if findings supported?

Peer Review - 3 providers objective + similar background/specialty to provider under review.

Notify provider of date of peer review + opportunity to submit a written statement. No right to appear or to attorney. Peer review determinations + recommendations

NO

Yes

Return to Status + destroy papers

END

Provider requests hearing?

END

No further appeal. 2499 to MEDCOM for possible report to NPDB.

Credentials Committee recommendations thru ECMS to MTF Commander – reviews and approves or disapproves + written notification of decision + hearing rights to provider.

NO

Yes

Ch 10 AR 40-68 Legal Standard: Preponderance Findings and Recommendations

Provider - Right to request reconsideration. Automatic appeal. Written notice of decision + basis

MTF

Commander

RMC

For review

Reconsideration

MEDCOM QM

OSJA

NPDB/State Agencies