Granting a practitioner a leadership title does not make him or her a leader. However, an individual who is selected or elected to be a department chairperson, medical staff officer, or committee chair is expected to provide significant leadership. But leadership entails more than chairing a meeting, signing credentials files, and putting out fires. Leadership requires the creation of a vision, the ability to communication that vision to others, and the drive to develop a game plan for achieving that vision. 

Peer review committee chairpersons or members often do not receive any kind of structured training to do their job. Typically, new members may have the support staff briefly go over the required tasks. Peer review committee meetings are prolonged, and reviewers struggle to perform, evaluate, and present cases fairly and efficiently.

Every year, the Drug Enforcement Administration (DEA) sets a specific quota regarding the number of opioid pills that drugmakers can produce in the United States. This quota is based on data collected from both the FDA and drugmakers. However, the DEA recently proposed a rule that would prevent the overproduction of opioids. Doing so would limit the excess quantities available for illegal use and distribution.  

A California Court of Appeals for Division Seven of the Second Appellate District reversed and remanded with directions a trial court’s decision, finding that the terms of an agreement between a physician and hospital cannot be enforced when they conflict with a state-mandated procedure.

Although the peer review coordinator is involved throughout the case review process, the coordinator has the primary responsibility at the beginning of case review and through the following four steps: case identification, case screening, review preparation, and physician reviewer assignment. It is important to note that these steps should be performed under the guidance of medical staff policies and procedures.

Delegated credentialing has the potential to improve enrollment turnaround times for providers, decrease paperwork for practitioners and staff, and reduce lost or delayed revenue. However, the process for attaining delegation status with commercial payers encompasses a number of critical steps to ensure compliance with National Committee for Quality Assurance (NCQA) credentialing standards. In the following Q&A, Amy Niehaus, MBA, CPMSM, CPCS, addresses questions from MSPs about attaining payer delegation.

CRC members can peruse all of the online articles from the October 2019 issues of CRCJ and MSB—as well as full-color PDFs—here:

• CRCJ
• MSB

To access the relevant full-issue PDF, select "DOWNLOAD FULL ISSUE" at the top of the page.