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For more than 20 years, Epstein Becker Green has been a strong proponent of medical staff management in various health care settings such as hospitals, managed care organizations, and medical group practices. Indeed, the firm represents some of the largest group practices in the country and numerous practice management companies. As such, Epstein Becker Green understands the wide range of federal and state laws and regulations affecting the legal relationships between physicians, hospitals, management entities, and other health care organizations. Firm attorneys have extensive knowledge of, and experience in, these complex relationships and the effects of these laws and regulations on medical staff issues such as bylaws, rules and regulations, peer review, corrective actions and provider reporting.

Working closely with medical staffs and health care organizations, Epstein Becker Green provides counseling and advice to medical staff leadership and health care organizations such as hospitals and specialty facilities. Firm attorneys have extensive experience in managing the legal issues surrounding credentialing and peer review recommendations and decisions in hospitals, managed care organizations and other health care organizations. Notably, Epstein Becker Green has successfully advised its clients with respect to trends in credentialing and peer review whereby fair hearing procedure requirements that traditionally applied to hospital medical staffs are being applied to managed care organizations. Our attorneys have drafted numerous sets of medical staff bylaws and credentialing and peer review policies and procedures and attorneys here have assisted health care organizations and medical staff members with fair hearing procedures when such procedures are necessary.

Epstein Becker Green provides complete legal support for medical staff and medical group practice development, including:

  • conducting legal audits of proposed structures and existing contracts and financial relationships;
  • development of practice management structures to conform to corporate practice of medicine, self-referral, antitrust, insurance and other requirements;
  • legal audits of compliance with federal and state employment laws; and
  • representation of medical groups in regulatory investigations and contract negotiations.

Epstein Becker Green provides complete legal support for all credentialing, peer review, and fair hearing issues in hospitals, managed care organizations, and other health care organizations including:

  • analysis and proposed revisions to medical staff bylaws;
  • restructuring of medical staffs;
  • advice and counsel regarding peer review issues;
  • counsel and advise clients regarding medical staff appointment/ reappointment and clinical privilege delineation for physicians and allied health professionals;
  • representation of clients during fair hearings;
  • counsel and advise clients regarding the National Practitioner Data Bank and the Health care Integrity and Protection Data Bank and state reporting requirements;
  • development of harassment and disruptive practitioner policies;
  • draft of contracts with practitioners to correct peer review and credentialing concerns;
  • management of issues related to protection of peer review documents and sharing of confidential peer review and credentialing information; and
  • representation in any litigation related to peer review and credentialing issues
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