Medical Staff

Ask the expert: What is the role of the appellate review committee?

Medical Staff Leader Connection, December 23, 2009

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The appellate review committee or panel, which is usually made up of members of the governing board, plays a limited role when a physician appeals a hearing judgment to the governing board, says John Harwell, Esq., a healthcare attorney based in Manhattan Beach, CA. The committee’s primary goal is to decide whether the hearing system is flawed and/or whether substantial evidence exists to support the hearing panel’s decision. The appellate committee cannot hear new evidence or weigh existing evidence.

“You don’t get to say there is more evidence to support A than B. If A was the decision, the only question is ‘was there enough evidence to support A?’ Although B might have been as likely a result, or even a better result, appellate bodies are not meant to do that,” says Harwell.

After determining whether the hearing panel accurately assessed the evidence, the appellate review committee can accept, reject, or modify the hearing panel’s recommendation. Appellate review committees can also remand the case back to the medical staff to retry the hearing with a fresh hearing panel.

This week’s question and answer were excerpted from “Fair hearings 101: Brush up bylaws to ensure a fair and streamlined appeals process” from the December 2009 issue of Credentialing and Peer Review Legal Insider.

 

 



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