Tenn. Comp. R. & Regs. 0800-02-20-.13 - REMOVAL OF A PHYSICIAN FROM THE REGISTRY
(1) The
Administrator may remove a physician from the MIR Registry. In doing so, the
Administrator shall first notify the physician in writing that he or she is at
risk of being removed from the MIR Registry. The Administrator may remove a
physician from the MIR Registry permanently or temporarily based upon any of
the following grounds:
(a) Misrepresentation
on the "Application for Appointment to the MIR Registry" as determined by the
Administrator;
(b) Failure to
timely report a conflict of interest in a case assignment, as determined by the
Administrator;
(c) Refusal or
substantial failure to comply with the provisions of these Rules, including,
but not limited to, failure to determine impairment ratings correctly using the
AMA GuidesTM, as determined by the
Administrator;
(d) Failure to
maintain the requirements of the Rules, as determined by the Administrator;
or
(e) Any other reason for the
good of the Registry as determined solely and exclusively by the
Administrator.
(2)
Written complaints regarding any MIR Registry physician shall be submitted to
the Program Coordinator. Upon receipt of a complaint regarding a MIR Registry
physician, the Administrator shall send written notice of the complaint (or in
cases arising under Rule 0800-02-20-.13(1), notice and grounds for possible
removal) to such physician, stating the grounds, and notifying the physician
that he or she is at risk of being removed from the MIR Registry.
(a) The physician shall have thirty (30)
calendar days from the date the Notice of Complaint in which to respond in
writing to the complaint(s), and may submit any responsive supporting
documentation to the Program Coordinator for consideration. Failure of the
physician to submit a timely response to the Notice of Complaint may result in
removal of the physician from the MIR Registry.
(b) The Administrator, in consultation with
the Medical Director and Program Coordinator, shall consider the complaint(s)
and any response(s) from the physician in reaching a decision as to whether the
physician shall be removed from the MIR Registry.
(c) Upon reaching a determination on the
complaint(s), the Administrator shall issue a written Notice of Determination
and set forth the basis for the decision in such Notice. The determination set
forth shall become final fifteen (15) calendar days after issuance of the
Notice of Determination, unless a timely request for reconsideration is
received.
(d) A MIR Registry
physician may seek reconsideration of an adverse decision from the
Administrator by submitting a request for reconsideration stating the grounds
for such reconsideration to the Program Coordinator within fifteen (15)
calendar days of the issuance of the Notice of Determination. The Administrator
may affirm, modify or reverse the initial determination upon reconsideration of
the initial decision. The Administrator shall issue a Notice of Determination
upon Reconsideration which shall be the final decision. If the Administrator
does not act on the request for reconsideration within twenty (20) calendar
days, then the request shall be deemed to have been denied, which shall be the
final decision.
(3) A
physician who has been removed from the MIR Registry by the Administrator may
apply for reinstatement one year after the date of removal by submitting a
written request to the Program Coordinator.
(4) In lieu of removing a physician from the
MIR Registry, the Administrator, at his or her sole discretion, may move the
physician to inactive status pending the fulfillment of additional AMA
GuidesTM training or other administrative
requirements, as designated in writing to the physician. MIR Registry
physicians moved to inactive status shall remain on the MIR Registry, but may
not:
(a) Be placed on the 100-mile list of
qualified physicians for a given dispute;
(b) Perform MIR evaluations; or
(c) Have recourse through reconsideration of
the Administrator's decision to move the physician to inactive
status.
Notes
Authority: T.C.A. ยงยง 50-6-102, 50-6-204, 50-6-205, and 50-6-233.
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