While most Healthcare providers and practice groups would prefer to focus on providing care to patients, one reality of the Business of Healthcare is that business disputes often arise. Like other businesses, a Healthcare practice may be exposed to many of the same day-to-day business disputes as any other business. Additionally, the Business of Healthcare has its own unique issues, such as compliance with state and federal Healthcare regulations and peer review proceedings.
At Jones & Keller, members of our Healthcare practice have a combined 100 years of experience litigation commercial disputes. We count among our members the former Solicitor General for the State of Colorado; the former chief of the Colorado Attorney General’s Anti-Trust Unit; and the former general counsel for the Colorado Medical Board. Our lawyers represent Healthcare providers and others throughout the litigation process, from initial investigations and settlement efforts through state and federal trial and appeal. We also represent physicians, dentists, nurses, chiropractors, and other Healthcare providers in administrative hearings and peer review proceedings, and anti-trust issues when a physician is denied privileges or barred from a facility.
Among the most valuable assets of most healthcare providers, including doctors, nurses, dentists, physician assistants, chiropractors and others, is his or her license. A provider’s license is essential to his or her professional reputation and livelihood. The loss or restriction of a medical license can have devastating results for all healthcare providers. Even the most prudent physician nurse or other provider can face inquiries from the Medical Board. Threats to licensure, including Medical Board complaints and peer review actions, must be taken seriously and addressed promptly.
Healthcare providers can face disciplinary actions from state Medical Boards for numerous reasons, including allegations of negligence, malpractice or substandard practice, inappropriate or excessive prescribing, sexual misconduct, mental or physical disabilities or illness, use of drugs and alcohol, fraud, and criminal convictions. Violations of the state Medical Practice Act can result in revocation, suspension, probation and fines. A provider who is subject to discipline from the state Medical Board can also face issues with hospital privileging and peer review actions. Similarly, doctors and nurses facing peer review issues can face discipline from the state Medical Board.
At Jones & Keller, our healthcare lawyers are adept at helping healthcare providers through all stages of the disciplinary process before both the Medical Board and peer review proceedings. If a Medical Board complaint is filed, an effective initial response can clear the air and help avoid or minimize formal action. If the matter proceeds to a formal disciplinary hearing before an administrative law judge, we provide skilled representation.
Our lawyers have represented several of Colorado’s regulatory bodies, including the Colorado Medical Board, the Colorado Boards of Dentistry and Nursing Home Administrators. We have also successfully represented practitioners before these and other boards, including the Colorado Board of Nursing.
Credentials and privileges are essential to the practice of medicine at hospitals and other healthcare facilities, and to acceptance by many insurance panels. Credentials and privileges control where physicians practice and what procedures they can perform.
At Jones & Keller, we represent healthcare providers who face credentialing, privileging and peer review issues – especially when these issues involve due process.
A Colorado hospital suspended the privileges of a physician. The hospital took years to conduct a hearing. Jones & Keller represented the physician in a suit against the hospital alleging that the hospital failed to follow its own by-laws that required a fair and timely review. Jones & Keller’s representation resulted in an appellate decision in the physician’s favor.
Our familiarity with the peer review process also allows us to ably advise healthcare facilities involved in peer review, to make sure that all proceedings comply with the policies and procedures of the medical staff bylaws.
Unfortunately, the peer review process is sometimes used by a hospital for economic rather than quality-of-care issues – to retaliate against an entrepreneurial healthcare provider who is seen as actually or potentially competing against the hospital or an influential practice group.
At Jones & Keller, we represent healthcare providers who feel that they are being disadvantaged in the peer review process by larger competitors. These include individuals, practice groups, provider-owned facilities like surgery and imaging centers, and practitioner joint ventures such as independent practice associations.
Jones & Keller’s healthcare group includes the former chief of the Colorado Attorney General’s Antitrust Unit and the former counsel for the Colorado Medical Board’s Committee on Anti-Competitive Conduct. Our attorneys represent clients in federal, state judicial proceedings and administrative and hospital proceedings that involve issues of fair competition.
For more information about how members of the Jones & Keller Healthcare Litigation practice can help you, please contact Jones & Keller, at 303-573-1600.