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 16.10.10.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
The following definitions apply to this section. All terms
				  not defined have their general dictionary meaning.
A.
"Adverse action"
means any
				discipline, sanction or other action, whether equitable, administrative, civil
				or criminal, affecting a licensee, applicant or other person falling under the
				jurisdiction of the Medical Practice Act. The term embraces any action
				affecting the licensee's or applicant's practice, including, but not limited to
				revocations, suspensions, probation, monitoring, restrictions, and stipulations
				or other limitations, as well as fines, penalties and financial settlements.
				The term also includes any action taken to avoid disciplinary action, a
				sanction, or another action. An action does not need to involve clinical
				competence or patient care or affect clinical privileges in order to be
				"adverse".
B.
"Adversely
				affecting"
means reducing, restricting, suspending, revoking, denying,
				or failing to renew clinical privileges, or membership in a health care entity
				to include: terminating employment for cause, or without cause when based on
				incompetency or behavior affecting patient care and safety, or allowing the
				licensee or applicant to resign rather than being terminated for such reasons.
				These actions do not include those instances in which a peer review entity
				requires supervision of a licensee or applicant for purposes of evaluating that
				licensee's or applicant's professional knowledge or ability.
C.
"Clinical privileges"
include
				privileges, membership on the medical staff, employment, and other
				circumstances under which a licensee or applicant is permitted by a health care
				entity to furnish medical care.
D.
"Termination of employment"
includes the termination of employment
				by a health care entity for cause, or without cause if related to clinical
				competence or behavior affecting patient safety/care, or allowing resignation
				in lieu of termination for such reason.
E.
"Health care entity"
means:
(1) a hospital, HMO, a physician group, locum
				tenens or staffing agency, or other health care institution that is licensed to
				provide health care services in New Mexico;
(2) an entity that provides health care
				services and that follows a formal peer review process for the purpose of
				furthering quality health care;
(3)
				a professional society or a committee, or agent thereof, of licensed health
				care practitioners at the national, state or local level, that follows a formal
				peer review process for the purpose of furthering quality health care,
				including without limitation a health maintenance organization or other prepaid
				medical practice which is licensed or determined to be qualified by any state;
				and
(4) a health plan or network
				that partners payers, employers and health care providers and professionals,
				including preferred provider groups, specialty groups, physician-hospital
				organizations and workers' compensation networks.