New Mexico Administrative Code
Title 16 - OCCUPATIONAL AND PROFESSIONAL LICENSING
Chapter 10 - MEDICINE AND SURGERY PRACTITIONERS
Part 10 - REPORT OF SETTLEMENTS, JUDGMENTS, ADVERSE ACTIONS AND CREDENTIALING DISCREPANCIES
Section 16.10.10.9 - REPORTING OF ACTIONS ADVERSELY AFFECTING CLINICAL PRIVILEGES
Universal Citation: 16 NM Admin Code 16.10.10.9
Current through Register Vol. 35, No. 18, September 24, 2024
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.
Disclaimer: These regulations may not be the most recent version. New Mexico may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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