A letter from the Medical Executive Committee recommending corrective action against your privileges, or a summary suspension, can put a 20-year career in doubt in a matter of days. If you’re a New York physician facing peer review, your clinical privileges, income, and National Practitioner Data Bank (NPDB) record are all on the line.
At Weiss Zarett Brofman Sonnenklar & Levy, P.C., we represent physicians at every stage of the peer review and credentialing process. If you have received a notice, contact our firm as early as possible so we can help you build your response.
What New York Law Requires Before a Hospital Can Limit Your Privileges
Two sets of laws bear upon how a New York hospital can limit your privileges. Federal law protects hospitals that employ fair hearing steps in good faith. New York law gives you a way to challenge the hospital’s actions after the internal hearing process is exhausted.
Federal hearing rights
The Health Care Quality Improvement Act (HCQIA), at 42 U.S.C. § 11112, protects hospitals from most money damages lawsuits when their peer review is fair and certain hearing rules are followed. The law lists steps that must be implemented. They include written notice of the proposed action and its reasons, at least 30 days to ask for a hearing, and at least 30 days’ notice of the hearing date. Under that model, you can bring an attorney, get a record of the hearing, and question witnesses. Hospitals don’t have to use these exact steps. Many bylaws follow them closely, so read yours to see what procedures are actually required.
New York’s added layer
New York Public Health Law § 2801-b bars a hospital from denying or reducing privileges without giving reasons, or if the reasons are not related to patient care, patient welfare, the hospital’s goals, or your character or competence. You can challenge that with a verified complaint to the Public Health and Health Planning Council (PHHPC). But the Department of Health’s guide to Section 2801-b says the PHHPC treats a complaint as premature if you skipped the hospital’s own due process procedures.
Why Your Medical Staff Bylaws Matter More Than the Statute?
Your medical staff bylaws are the rulebook for your peer review hearing, and a hospital that breaks its own rules can give you another argument to challenge the adverse action.
Federal law doesn’t require a set hearing process. Bylaws fill that gap, spelling out who sits on the hearing panel, how many days you get to respond, and what standard of proof applies. Our founding member David A. Zarett co-authored the chapter on hospital medical staff membership and privileges in the Legal Manual for New York Physicians, and we typically start these cases by reading the bylaws line by line to fully understand your rights and the limitations if any imposed on the hospital.
The Voluntary Restriction That Still Gets Reported
A voluntary agreement to stop practicing during a peer review investigation can land in the National Practitioner Data Bank (NPDB). NPDB guidance treats a restriction you agree to while under investigation as reportable when the other reporting rules are met. Before you sign anything described as informal, get advice.
How to Prepare for a New York Peer Review Hearing?
Preparing for a peer review hearing starts the day the notice arrives. Among other things:
- Calendar every deadline in the notice and the bylaws.
- Ask in writing for the witness list, the charts under review, and any outside reviewer’s report.
- Line up an independent expert in your specialty to address the standard of care.
- Hire a New York peer review hearing attorney before you write your response, because the hearing record can shape any later review, including a PHHPC complaint.
What Happens If a Peer Review Hearing Goes Against You?
An adverse peer review decision that is affirmed after appellate review usually triggers reports that follow you beyond one hospital. Under New York Public Health Law § 2803-e, hospitals must report many privilege actions to the Department of Health within 30 days. That includes actions tied to impairment, incompetence, malpractice, misconduct, or patient safety. It also includes resigning to avoid discipline. The Department of Health is home to the Office of Professional Medical Conduct (OPMC). Final actions based on your competence or conduct that last more than 30 days must also be reported to the NPDB within 30 days of the action.
Frequently Asked Questions
Can a hospital suspend my privileges before a hearing in New York?
Yes, most bylaws allow a summary suspension for an immediate risk to patients. Federal law still protects the hospital in that case if waiting could put someone in imminent danger. But a hearing or another fair process has to follow.
Do I have to resign if the hospital asks me to?
No. And resigning while you’re under investigation may not make the problem go away. Federal and New York reporting rules treat a resignation to avoid investigation or discipline as reportable.
Can my competitor sit on the hearing panel?
Generally, no. Under the federal model many hospitals follow, panel members and hearing officers shouldn’t be in direct economic competition with you. Some hospitals use an arbitrator you both agree on instead. Check your bylaws for the exact rule. Raise any conflict in writing before the hearing starts.
Weiss Zarett Brofman Sonnenklar & Levy, P.C.: Your Healthcare Law Firm
A notice of proposed action can make it hard to think about anything else, and the pressure to respond quickly is real. If you’ve received a notice or have questions about your next steps, call our office today. Let’s review your options and move forward together. Contact our firm today.
