10A NCAC 22F .0509. DISQUALIFICATION OF BOARD MEMBERS

(a)  If, at any time, a member of the Peer Review Board believes that he cannot perform his function as a member of the Board in a fair and impartial manner due to personal interest or bias, he shall immediately disqualify himself.

(b)  No person who has been directly responsible for a patient whose case is being reviewed or who has any financial interest in any aspect of the matter or who has participated in the prior investigation of the provider case may serve as a member of the Board considering the case or advise or assist the Board in its deliberations.

(c)  If a provider believes any member of the Board is unable to perform in a fair and impartial manner, he shall submit a written statement setting out his reasons why the Board member should be disqualified.  The statement shall be presented to the Director, Division of Medical Assistance, or his designee, who shall make a determination, following a meeting with the challenged board member and the challenging provider, as to whether or not the Board member shall be allowed to continue as a member of the Board during the case review proceedings.

(d)  In the event that a board member is disqualified to sit as a member of the Board during a particular case, a member from the appropriate Medicaid Agency on‑call consultants shall be selected by the Director, Division of Medical Assistance or his designee to fill the vacancy created by such disqualification, provided this can be done without delaying the peer review.  If the disqualified board member is one of the Dental District Committee members, then the Director, Division of Medical Assistance or his designee shall choose another member of that district committee to fill the vacancy created.

 

History Note:        Authority G.S. 108A‑25(b); 42 C.F.R. Part 455; 42 C.F.R. Part 456;

Eff. May 1, 1984.