- NPRC Fair Hearing Services

Outsourcing Components of a Fair Hearing

Conducting a Fair Hearing as a result of an adverse peer review action is often a significant undertaking for hospitals. Although guided by the Hospital and Medical Staff Bylaws and the hospital’s Fair Hearing Plan, the actual conduct of a hearing requires attention to detail to ensure that it is, in fact, conducted fairly, as well as to minimize the time and resources devoted to the process. Most hospitals find this to be a difficult balancing act, particularly since hearings are not a common occurrence. Using the NPRC Fair Hearing Services, whether as a whole or as needed components, is the streamlined solution to an impartial, professional, and accurate Fair Hearing process and Fair Hearing Report.

Working with legal counsel, NPRC can provide one or more expert peer reviewers to serve as members or advisors to the Hearing Panel, a professional Hearing Officer to oversee the hearing process, and various levels of services to ensure that the Hearing Panel Report accurately reflects the hearing process and the findings and conclusions of the Hearing Panel.

NPRC Expert Peer Reviewers as Hearing Panel Members or Advisors

NPRC Peer Reviewer as an Advisor to the Hearing Panel. Where permitted by the hospital’s bylaws or by agreement of the parties to the Fair Hearing, NPRC can provide one or more expert physicians in the same specialty as the practitioner requesting the Fair Hearing to serve as an advisor to the Hearing Panel. Engaging an NPRC Peer Reviewer as an advisor to the Hearing Panel has the following benefits:

The NPRC Peer Reviewer is an unrelated party, objective, and immune to hospital politics.
As a provider in the same specialty, the NPRC Peer Reviewer can provide more in-depth clinical insight for the Hearing Panel, resulting in a more accurate and fair outcome.
If amenable to the governinig policies and the parties to the hearing, the NPRC Peer Reviewer can attend the hearing via video connection to reduce costs.

NPRC Peer Reviewers as Members of the Hearing Panel. Where permitted by the hospital’s bylaws or by agreement of the parties to the Fair Hearing, NPRC can also provide one or more expert physicians in the same specialty as the practitioner requesting the Fair Hearing to serve as members of the Hearing Panel. In addition to the benefits outlined above regarding an advisory peer reviewer, engaging the NPRC Peer Reviewers as members of the Hearing Panel avoids the delays that often occur when the Hearing Panel is composed of medical staff members, requiring tedious scheduling of multiple physicians with already long work schedules. A Hearing Panel composed of one or more NPRC Peer Reviewers means that the hearing can be conducted on a continuous basis, within designated hours on consecutive days, to achieve a quick and accurate conclusion at less cost.

The NPRC Hearing Panel Report Editor

The Hearing Panel Report issued at the conclusion of a Fair Hearing is the culmination of all of the efforts to provide a hearing that is fair, impartial, and in conformance with the Hospital and Medical Staff Bylaws and other applicable policies and procedures. Therefore, it is essential that the Hearing Panel Report is accurate and clearly communicates the Hearing Panel’s findings and conclusions. Otherwise, the Hearing Panel Report can create additional issues, negating all of the time and effort that went into conducting the hearing and delaying resolution for the hospital and the practitioner under review.

The NPRC Report Editor as an Advisor or Editor. Where permitted by the hospital’s bylaws or by agreement of the parties to the Fair Hearing, the NPRC Report Editor can serve as an editor of the final Hearing Panel Report or as advisor to the Hearing Panel and/or the Hearing Officer regarding the editing of the final Hearing Panel Report. As an objective expert in peer review with experience editing thousands of peer review cases, the NPRC Report Editor is uniquely qualified to ensure the accuracy and completeness of the Hearing Panel Report without bias.

The NPRC Report Editor Services. In the role of editor of the final Hearing Panel Report or as advisor to the Hearing Panel and/or the Hearing Officer regarding the editing of the final Hearing Panel Report, the NPRC Report Editor may be engaged to perform any or all of the following services:

Attend, by audio or video, the pre-hearing conferences.
Receive and review all reports and submissions to the Hearing Officer.
Be present in person or by video at the Fair Hearing to take notes.
Advise the Hearing Officer regarding the final Hearing Panel Report or be responsible for working with the Hearing Officer and the Hearing Panel to edit the Hearing Panel Report.

In addition to direct, ongoing gathering of information during the course of the hearing, the NPRC Report Editor may also be engaged at the end of the hearing as an advisor or editor to the Hearing Panel and/or the Hearing Officer regarding the editing of the final Hearing Panel Report. At the conclusion of the hearing, the Hearing Officer, with assistance of legal counsel, provides the NPRC Report Editor with all of the reports and other submissions to the Hearing Officer, relevant portions of the hearing transcript, and a draft Hearing Panel Report prepared by the Hearing Panel and/or the Hearing Officer. Using years of peer review experience, the NPRC Report Editor will then work with the Hearing Officer and the members of the Hearing Panel to edit the Hearing Panel Report. Once completed, the final Hearing Panel Report will then be submitted to the Hearing Panel and the Hearing Officer for approval.

The NPRC Hearing Officer

Where permitted by the hospital’s bylaws or by agreement of the parties to the Fair Hearing, NPRC can provide the Hearing Officer. As the person responsible for overseeing the hearing process, the Hearing Officer’s role in accomplishing a successful Fair Hearing is critical. Engaging NPRC to provide the Hearing Officer provides the following benefits:

The NPRC Hearing Officer is an unrelated party, objective, and immune to hospital politics.
The NPRC Hearing Officer is trained in the conduct of fair hearings and a peer review expert.
The NPRC Hearing Officer will conduct the Fair Hearing as a hearing, as intended, not as a trial.
The NPRC Hearing Officer will understand the hearing process, ensuring that all parties adhere to the processes of the Fair Hearing plan designed to provide a fair and accurate hearing in a timely manner.
The NPRC Hearing Officer will be dedicated to the hearing process, alleviating any scheduling problems.
The NPRC Hearing Officer will be paid a fixed fee and will not bill by the hour, keeping the hearing focused and within designated time limits.
If permitted by its bylaws, a hospital may use the NPRC Hearing Officer as the Hearing Panel to reduce costs.

Together, these benefits will facilitate an objective review of the facts, while reducing the length and cost of the Fair Hearing.

NPRC as Facilitator of the Overall Fair Hearing Process

If permitted by the hospital’s bylaws or by agreement of the parties to the Fair Hearing, NPRC can combine these multiple Fair Hearing services to provide a comprehensive, impartial Fair Hearing process. More specifically, this comprehensive approach provides the following benefits:

NPRC is an unrelated party, objective, and immune to hospital politics.
As experts in providing peer review services, NPRC can put easy to follow procedures in place that, working with legal counsel, conform to the Hospital and Medical Staff Bylaws and the hospital’s Fair Hearing Plan.
If there are concerns about the Fair Hearing Plan of the hospital, NPRC can, upon agreement of the parties and subject to the hospital’s bylaws, provide a fair, efficient, and simple to follow Fair Hearing Plan.
NPRC can provide the Hearing Officer.
NPRC can provide the Hearing Panel.
NPRC can provide the NPRC Report Editor to edit the Hearing Panel Report.
NPRC can manage pre-procedure submissions and actions in accordance with the hospital’s Fair Hearing Plan or the NPRC Fair Hearing Plan.
NPRC can conduct the hearing proceedings in an expedited manner, completing the process within the time period specified in the hospital’s Fair Hearing Plan (or, if using the NPRC Fair Hearing Plan, within the specified two day period).