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Are health centers required to report adverse clinical privileges actions?

Yes. Health centers are required to report certain clinical privileges actions taken against physicians and dentists, though they can also report those same actions when taken against other health care providers, such as nurses and physician assistants.

Reportable adverse clinical privileges actions must meet the following criteria:

  1. Any professional review action that adversely affects the clinical privileges of a physician or dentist for a period of more than 30 days; or
  2. Accepting the surrender of clinical privileges, or any restriction of such privileges by a physician or dentist:
    1. While the physician or dentist is under investigation by a health care entity relating to possible incompetence or improper professional conduct; or
    2. In return for not conducting such an investigation or proceeding.

Clinical privileges include privileges, medical staff membership, and other circumstances (e.g., network participation and panel membership) in which a physician, dentist, or other health care practitioner is permitted to furnish medical care by a health care entity.

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