'Economic credentialing' could cause legal problems

If your hospital uses economic criteria to decide whether to appoint or reappoint a physician to its medical staff, you could open yourself to a host of legal problems, according to Brian Peters, a health care attorney with the Philadelphia-based law firm Post & Schell. Some hospitals have so-called "economic credentialing" policies written into their bylaws.

Economic--or "institutional" or "citizenship"--criteria that some hospitals use for appointment or reappointment include the following questions:

• How many patients do you think you can admit within a year?
• What is the average length of stay for your patients?
• Where is your office located? Would you leave it and move here?
• Do you have relationships with our competitors? Would you end those relationships?
• How many health plans do you deal with? Would you drop them if their reimbursements fell too much?

Asking any of these questions during appointment/reappointment proceedings could invite legal action based on federal antitrust statutes, employment discrimination, or fraud and abuse, Peters says. Physicians could also bring legal action if you try to determine whether they've kept their promises during appointment/reappointment proceedings, or threaten disciplinary action for not meeting patient quotas.