Due Process (#1)

Question 1

What is due process?

Answer 1

Formal proceedings with established rules & principles

Question 2

What is an appeal?

Answer 2

Formal request for reconsideration of an adverse action

Question 3

What is a hearing?

Answer 3

Evidence & arguments are presented to person/ body with decision making authority

Question 4

What is substantive due process?

Answer 4

Requires proof that an adverse recommendation is reasonable

Question 5

What is procedural due process?

Answer 5

Requires adherence to guidelines for communications once an adverse decision has been made.

Question 6

Due Process in Hospital Settings

Answer 6

TJC, AAAHC: Required

HFAP: Required; process can differ for MS vs. AHP

Question 7

Due Process in MCOs

Answer 7

NCQA: Required