N.M. Admin. Code § 16.10.10.9

Current through Register Vol. 35, No. 20, October 22, 2024

Section 16.10.10.9 - REPORTING OF ACTIONS ADVERSELY AFFECTING CLINICAL PRIVILEGES

A. All health care entities, licensees and applicants shall report any action adversely affecting the clinical privileges of the licensee or applicant within thirty days after the action is taken.

B. Actions the health care entity must report include, but are not limited to:

(1) any professional review action adversely affecting the clinical privileges of a licensee or applicant, except as provided in Subsection C of this section;

(2) the health care entity's acceptance of the surrender of clinical privileges or any restriction on such privileges as a result of or relating to possible incompetency or improper professional conduct while the licensee or applicant is under investigation, or in return for the health care entity's decision not to conduct an investigation or proceeding;

(3) any professional review action taken by a professional society adversely affecting the membership of a licensee or applicant in the society;

(4) the failure to complete medical records where the failure relates to the licensee's or applicant's professional competence or conduct, or the failure could or did adversely affect a patient's health or welfare; and

(5) a positive drug test for illegal substances, alcohol or prescribed or un-prescribed medications not supported by appropriate diagnosis (the board will not require name of the licensee or applicant if the licensee or applicant has voluntarily self-reported to the New Mexico health professional wellness program (HPWP), or any successor organization).

C. Reports of actions adversely affecting clinical privileges must include, at a minimum:

(1) the name, license number, and social security number of the licensee or applicant;

(2) a description of the act(s) or omission(s) or other reasons for the action or for the surrender of privileges;

(3) the action taken, the date the action was taken, and the effective date of the action; and,

(4) any official addendum to the licensee's or applicant's data bank report.

D. A health care entity is not required to report to the board:

(1) actions based on the licensee's or applicant's association, or lack of association, with a professional society or association;

(2) actions based on fees, advertising, or other competitive acts intended to solicit or retain business;

(3) actions based on the licensee's or applicant's participation in prepaid group health plans;

(4) actions based on the licensee's or applicant's association with, supervision of, delegation of authority to, support for, training of, or participation in a private group practice; or

(5) any other matter that does not relate to the competence or professional conduct of a licensee or applicant; and

(6) suspensions of clinical privileges resulting from a failure to complete medical records, except to the extent such failures are reportable under Paragraph (4) of Subsection A of this section, maintain insurance or perform other administrative obligations.

E. Subsequent disposition of an action adversely affecting the licensee or applicant, even if favorable, does not alter a health care entity's duty to report the action.

N.M. Admin. Code § 16.10.10.9

16.10.10.9 NMAC - Rp 16 NMAC 10.10.8.3, 7/15/01; A, 4/18/02; A, 1/6/12; A, 7/2/12; A, 2/14/13, Adopted by New Mexico Register, Volume XXIX, Issue 17, September 11, 2018, eff. 9/17/2018