The Kadlec Appeal –
Decision Against Hospital Reversed!
Does this Change How Hospitals Should Respond to Credentialing Inquiries?
Audio CD/MP3
Recorded May 28, 2008
1:00 - 2:30 pm (Eastern Time)

Faculty: Barbara Blackmond & Phil Zarone

The Fifth Circuit Court of Appeals has reversed an important aspect of the Kadlec decision.

The trial court ruled that a Louisiana hospital had a duty not to omit "material" negative information about a physician's impairment when it responded to a credentialing inquiry from another hospital.

The court of appeals found that the hospital's duty was more limited. It ruled that the Louisiana hospital did not have a duty to disclose negative information about the physician to the inquiring hospital. Specifically, the court ruled that once the Louisiana hospital chose to respond, it had a duty not to make "affirmative misrepresentations."

Does this new decision mean that there is no longer any potential for liability in responding to reference requests as long as no negative information is provided (i.e., by using the "name, rank and serial number" approach)? Is "ask, but don't tell" the right answer for credentialing?

Every hospital will be on both sides of this issue, because original source verification is still a credentialing requirement. Candor – with appropriate safeguards – or, at the very least, flagging an issue is still the right approach. But most medical staff offices don't have the time or resources to respond in detail to all credentialing inquiries from other hospitals, managed care organizations and health plans.

So what's a hospital to do?

Join Barbara Blackmond and Phil Zarone, attorneys at Horty Springer, as they discuss strategies and policy guidelines for providing accurate information, while conserving valuable resources of physician leaders and medical staff professionals.

Specifically, Barb and Phil discuss:

• What information can and should be provided if the individual about whom information is requested has been the subject of formal adverse action?
• What about lesser steps, such as focused review, conditions of professional conduct, and performance improvement plans? Isn't that information that most medical staff leaders would like to know about an applicant for appointment or reappointment?
• Can hospitals rely on the general release provided with a credentialing inquiry? What should you put into bylaws, credentialing policies and application forms?
• What if the hospital has entered into a settlement agreement with a physician specifying the manner in which credentialing inquiries will be handled?
• Can hospitals in a system or even unaffiliated hospitals in a community develop efficient ways to exchange information for reappointment verification for practitioners on multiple staffs without risking a waiver of state peer review protection?
• Can hospitals develop alternative, standardized communications to fit the most common situations?
• What should hospitals do if they receive a request for payment for a reference inquiry?

Audio CD or MP3: $225

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