Peer Review and Credentialing

Fenton Nelson has been widely recognized as a leader in the area of physician peer review and credentialing. We represent physicians and other healthcare providers throughout all phases of medical staff privilege disputes, including investigations and peer review hearings.

When peer review bodies restrict privileges or even when physicians resign during investigations, the consequent reporting to the Medical Board of California under California Business & Professions Code Section 805 and to the National Practitioner Data Bank can wreak havoc on physicians’ lives.  Often, physicians are caught off-guard by the threat of reporting of privilege restrictions, suspensions, and non-renewals.  We work with our clients to avoid reportable events and defend our clients against peer review proposed actions in staff privilege hearings.

We are known for landmark decisions expanding physician rights, such as our victory in Sahlolbei v. Providence Healthcare, Inc. (2003) 112 Cal. App. 4th 1137.  In the case of Hayes vs. Cedars Sinai, Fenton Nelson's victory established the right of a physician to a hearing when his application for staff privileges was denied.  Following the landmark case of Potvin v. Metropolitan Life Ins. Co (2000) 22 Cal.4th 1060, founding partner Henry Fenton received a Lawyer of the Year award for his instrumental role in expanding the fair procedure rights of physicians to the managed care context.  In recent years, Fenton Nelson attorneys have represented numerous physicians employed by the California Department of Corrections and Rehabilitation in a wave of peer review actions within the state prison medical system flowing from Plata v. Davis.

In addition to our leadership role on behalf of physicians, Fenton Nelson also serves as medical staff counsel to several physician-controlled medical staffs and works with provider-owned healthcare facilities across California to ensure compliance with the requirements of the peer review and credentialing process. We are relied upon as authorities on all aspects of the peer review and credentialing process.  Our attorneys have also been asked to serve as hearing officers in peer review hearings.