Complaints to Professional and Regulatory Bodies
in Bill Sage, Glenn Cohen, and Allison Hoffman, eds., The Oxford Handbook of American Health Law (2017)
Posted: 25 May 2015 Last revised: 19 Sep 2017
Date Written: May 21, 2015
This chapter focuses on professional and regulatory bodies to which patients can lodge complaints and other concerns over the quality of care provided by medical practitioners and healthcare institutions. It first considers state regulation of professional licensing boards, together with the procedures employed by medical boards for patient complaints, as well as the challenges and criticisms faced by such boards with respect to their approach to complaint investigation and disciplinary enforcement. It then turns to federal regulation of providers and institutions that participate in Medicare and Medicaid, with particular reference to the Centers for Medicare and Medicaid Services. It also examines private organizations, such as the Joint Commission (formerly the Joint Commission for the Accreditation of Health Organizations) and specialty medical associations. Finally, the chapter looks at online consumer reviews and healthcare ratings websites as alternative mechanisms for patient reporting and complaints.
Keywords: licensing, discipline, accreditation, regulation, oversight
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