One of the most highly regulated sectors in the U.S., the healthcare industry is undergoing significant changes. The use of multiple business arrangements within the sector complicates business relationships and leads to frequent disputes. We can help.
Our health law practice offers a variety of alternative dispute resolution options specific to the needs of the healthcare sector, including mediation, arbitration, and service as hearing officers. Our representation combines deep expertise in healthcare law with a keen understanding of the medical, technical, operational, business and, at times, deeply emotional, issues that are inherent in healthcare conflicts.
There are numerous benefits to choosing alternative dispute resolution. The reduction of expense, time, and disruption are, of course, the most obvious. However, we find that it’s the preservation of the relationships among the involved parties that is most valuable.
We have worked successfully with hospitals, physicians and physician groups, medical staffs, healthcare provider groups and academic institutions on a broad range of disputes, involving:
- Dysfunction between boards, medical staffs, administration, and management groups
- Employment matters including workplace harassment and discrimination under DFEH and EEOC
- False Claims Act
- Insurance plans
- Medical malpractice
- Medicare and Medicaid
- Patient safety claims
- Payment and reimbursement
- Peer review/corrective action disputes including Mandamus Actions and whistle blower and retaliation
- Physician substance abuse and other well-being issues
- Risk management
HEARING OFFICER SERVICES
We have served as Hearing Officers in excess of 100 cases. Our team includes one of the most respected hearing officers for medical staff disputes in California and the Co-Chair of the Hearing Officer Training Committee for the California Society for Healthcare Attorneys. Our Hearing Officers are certified by the California Society of Healthcare Attorneys Hearing Officer Program and the AHLA. Examples of the types of hearings we have handled include:
- Presided over the Judicial Review Hearing that led to the published decision in Sadeghi v Sharp Memorial Medical Center-Chula Vista, 221d Cal. App. 4th 598 (2013), which, among other issues, addressed and confirmed several significant rulings faced by Hearing Officers in complex and protracted hearings. This hearing required 43 hearings and over two and a half years to conclude.
- A complicated matter involving a large medical service provider and a physician whose application for medical staff privileges had been denied.
- Served as the Hearing Officer in a matter involving the summary suspension of a neurosurgeon, where the medical staff bylaws allowed attorneys to be in the hearing room to provide advice and counsel, but not as advocates. The physician’s request to allow his attorney to become a hearing advocate in violation of the bylaws on the basis of the physician’s claim he was emotionally incapable of presenting his own case in pro per was denied. The decision was upheld in a mandamus action filed in Superior Court by the physician.
- Presided as a Hearing Office in a case that is currently pending before the California Supreme Court. The issue involving a doctor’s assertion of whistleblower status under H&S Section 1278.6 allows him to defeat defendant’s anti-SLAPP motion under CCP 425.16 and the California Supreme Court’s decision in Park v. Board of Trustees, 2 Cal 5th 1057 (2017).
- Served as Hearing Officer in a protracted matter involving more than 55 charges brought against a Physician by a Medical Staff, both clinical and behavioral in nature. The hearing extended over three years and in excess of 75 hearing sessions.
- Served as Counsel to an Appeal Board/Appeal Committee in Peer Review hearings where a Physician and Medical Executive Committee had appealed the findings of a JRC.
- Represented Healthcare Providers in first trial under Medical Staff Self Governance Statute, B&P 2282.5
Our experience representing a variety of entities on all sides of a dispute provides a thorough understanding of the issues and an enhanced ability to bring resolution that is quick and less costly than litigation.
- Arbitrated an appeal for the summary suspension and termination of medical staff privileges for a physician who failed to disclose that he was being investigated by the Medical Board. Neither party appealed the decision.
- Designated as a sole arbitrator under a provision in the medical staff bylaws which provided for a preliminary hearing before a Judicial Review Committee or Hearing Officer sitting as sole arbitrator, to try separately from the hearing on the suspension of medical staff privileges of a surgeon faced with charges of clinical and behavioral deficiencies. Following the ruling, and in the role of Hearing Officer, presided over a Judicial Review Committee charged with determining whether the summary suspension and recommendation for revocation were reasonable and warranted.
- Designated by counsel for both the physician and an international service provider to act as the sole arbitrator. The disagreement between the parties was if the provider’s denial of the physician’s application for medical staff privileges, after a hiatus of four years, was reasonable and warranted.
We serve as active mediators between parties and are often successful in obtaining an early resolution and avoiding the need for further action.
- Mediated a pre-lawsuit claim against a major medical center alleging that the harassment by members of the medical staff was responsible for the death of the claimant. The matter settled for six figures, less than the cost of defense.
- Mediated a recommended corrective action against a prominent member of an academic medical staff. The matter was settled without the necessity of a report to the Medical Board of California or the National Practitioners Data Bank.
- Mediation of a dispute between a major pharmaceutical chain and a former pharmacist. The issue included a claim of invasion of privacy, theft of proprietary information, and unfair competition and the accusation of improperly using patient and client contact information to open a competing pharmacy.
- Mediated a long-standing dispute between the medical staff of a major hospital and a neurosurgeon who claimed retaliation.
- Mediated many peer review cases and tort claims against hospitals and medical staffs.