Daniel Conway | Military Attorney
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HEALTH CARE PROVIDER ACTIONS / Quality assurance investigations / summary suspensions / peer review hearings

Medical providers in the military, whether service members themselves or contracted providers, can find their medical license and their livelihood under attack through a Quality Assurance Investigation (QAI). The QAI process marks the initiation of adverse actions against a provider’s ability to practice medicine in the community. It is initiated at the discretion of the Privileging Authority with the purpose of examining any suspected misconduct, impairment, incompetence, or other conduct that could adversely affect the health or welfare of a patient or staff member. However, these investigations have been initiated as a means to harass and retaliate against medical providers when subjective disagreements arise concerning patient care or in instances when a provider simply does not “fit” into his or her respective hospital or health care clinic.
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Once a QAI has been initiated, the provider is often placed on summary suspension. This prevents the provider from being assigned any clinical duties involving the privilege/practice under investigation, being assigned to another treatment facility, or executing Permanent Change of Station orders to another treatment facility. When a provider has been placed under summary suspension for more than thirty (30) days, the suspension action is reported to the National Practitioner’s Databank, the provider’s state(s) of licensure, and other applicable certifying and regulatory agencies. Unfortunately, these investigations can take several months to complete and often result in the provider having to respond to attacks on multiple fronts.

After the QAI is completed, the provider is notified of the findings and recommendations of the investigating officer and provided an opportunity to respond to those findings within fifteen (15) calendar days of receipt of the investigation. It is always recommended that the provider take this opportunity to explain and justify their actions with specific patients, as failure to do so often results in total deference to the recommendations of the investigating officer.
Once the time period for responding to the QAI findings has elapsed, the investigation packet and any response submitted by the provider are forwarded to a Credentials Committee/Function, which is responsible for reviewing the report and making a recommendation to the provider’s Privileging Authority. These recommendations can range from reinstatement of the provider’s clinical privileges to restriction of privileges, reduction, and, in some cases, outright revocation of privileges.

Restriction or revocation of privileges can carry severe collateral consequences for the provider. Military members who have their privileges revoked often find themselves subject to separation proceedings as a result of the privileging action taken. This might also result in recoupment actions to recover bonuses paid to the member.
If you happen to find yourself the subject of a QAI or similar investigation into your practice, such as when you have been flagged as a “significantly involved provider,” you should always exercise the due process rights that are afforded to you and ensure you have adequate representation in the matter, as your career and livelihood depend on it.
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© COPYRIGHT 2019. ALL RIGHTS RESERVED. 
The information on this page is informational in nature. Nothing on this or associated pages should be construed as legal advice for a particular case. Likewise, the information on this website does not constitute the creation of an attorney-client relationship. No representation is made that the quality of legal services to be performed is greater than the quality of legal services performed by other lawyers.
  • Practice Areas
    • Correcting Military Records >
      • Evaluation Report Appeals
      • Reprimand Appeals
      • Family Advocacy Program Appeals
      • Discharge Review Boards
      • Cadet Misconduct
      • Titling Actions
      • Military Protective Orders
    • Separation Boards
    • Military Medical Malpractice Claims
    • Forms, Downloads, and Regulations
  • Military Crimes and Defenses
    • Military Law >
      • Court-martial Information >
        • Know Your Rights
        • Court-Martial Rules >
          • Pretrial Confinement
          • Unlawful Command Influence
          • Article 31 Violation
          • Military Rule of Evidence 412
          • Involuntary Statements
          • Failure to State an Offense
          • Wheeler Factors
      • Court-Martial Defense >
        • Military Sexual Assault Defense
        • Military Drug Defense >
          • Drug Detection Windows
          • Marijuana
          • Cocaine
          • Morphine and Heroin
        • Disrespect Offenses
        • Conspiracy Cases
        • False Statements >
          • Obstruction of Justice
        • Use of Force
        • Assault Cases
        • Conduct Unbecoming
      • Court-Martial Appeals >
        • Petitions for a New Trial
        • Insufficient Evidence
    • Introduction
    • Article 77 Principles
    • Article 78 Accessory After the Fact
    • Article 79 Lesser Included Offenses
    • Article 80 Conspiracy
    • Article 81 Attempts
    • Article 82 Solicitation
    • Article 85 Desertion
    • Article 86 AWOL
    • Article 88 Contempt Towards Officials
    • Article 92 Failure to Obey an Order
    • Article 93 Maltreatment
    • Article 107 False Official Statement
    • Article 112a Wrongful Use of a Controlled Substance
    • Article 119 Manslaughter
    • Article 119b Child Endangerment
    • Article 121 Larceny or Wrongful Appropriation
    • Article 125 Kidnapping
    • Article 133 Conduct Unbecoming
    • Article 134 Bribery and Graft
    • Article 134 Indecent Language
    • Article 134 Obstruction of Justice
  • Firm History
    • Films
    • Books
    • Sketches
    • My Lai
    • Abu Ghraib
    • Haditha
    • MARSOC
    • The Stryker 5
    • Gary Myers
  • Results
  • Blog