No more Mr. Niceguy. It started as “better guidance” for prescribers as concerns mounted that the over-prescription of opioid pain medications was feeding a sharp rise in addiction to illicit forms, including street-sourced pills and heroin. But it has turned into well-coordinated federal and state enforcement actions against physicians and nurses, as well as their… [Read More]
Using proactive external peer review to mitigate the risk of high-dollar lawsuits Medical necessity investigations and lawsuits are a significant threat to healthcare providers, especially those that rely on internal medical staff peer review programs to identify adverse patterns in clinical behavior, according to the new brief Medical Necessity: Checks and Balances Most Hospitals Don’t… [Read More]
9/13/2018 – Greeley CMO Rick Sheff, MD, is joined by trusted legal counsel to explore medical necessity. Recent CMS/OIG settlements in the hundreds of millions have hospitals and systems thinking twice about trusting the medical staff’s regular peer review process to identify challenges and take proactive steps if/when self-reporting is warranted and appropriate. Watch Now!
Hospitals and medical staffs all too often experience predictable areas of strife for which external peer review can prove to be a useful conflict resolution tool. We’ll bet you have at least three of these going on right now. You are not alone. Trust Issues When competing physician groups in the same specialty must conduct peer review… [Read More]