One term Governor. Virginia is the only state with a one term Governor. This substantially limits his influence. However, he does have line item veto and amendment authority.
The first reaction of a health care professional who has received a notice of summary suspension is usually: “How did this happen? How can they take my license without notice or a hearing?”
This insight will explore some of the issues involved in public policy mediations. In the typical public policy mediation, special interests have been battling over an issue for several years at the General Assembly. In order to reach a compromise, they hire a neutral mediator to negotiate a solution outside of session. This solution is then presented to the next General Assembly for enactment.
Are public policy mediations good or bad? Without a doubt, they are a good thing. Parties have the opportunity to develop a compromise that benefits both sides. Just as importantly, a complex issue receives the kind of careful and informed consideration that is impossible during the legislative session.
An example of a recent issue handled by public policy mediation is the workers compensation fee schedule. Participants included physicians, hospitals, employers, insurers, and attorneys. While the mediation itself was not successful, the parties did reach an amicable settlement the next year. This outcome is typical of many mediations. At first glance, they appear unsuccessful because the parties did not seal an agreement at the end of the process. But they succeed ultimately, usually during the next legislative cycle.
Public policy mediation has grown in popularity for the same reasons that traditional mediation has:
• More control over the outcome;
• More predictability; and
• Avoidance of worst case scenarios.
Public policy mediations are often triggered by legislators telling the stakeholders, “We’re sick of this fight. If you don’t work it out, we will . . . and you may not like what we come up with.” This implied threat is a key feature of successful mediations. In the absence of the threat, or “stick”, the parties will not be very motivated to make the necessary compromises. In the case of the workers comp fee schedule, there were clear messages from the Speaker of the House and other legislative leaders that the “usual and customary” standard for calculating medical fees had to change.
What should you watch out for? First, you must have the right people at the table. If a key stakeholder isn’t involved, it may derail passage of the compromise. Second, you must have a legislative champion who can get the compromise passed. Third, you should not have too many people at the table. If there are too many bodies, effective negotiation is impossible and participants tend to grandstand.
After a complaint is filed, one of the first steps taken by the Department of Health Professions is to interview the licensee. The interview is conducted by an investigator from the Enforcement Division. In our experience, most investigators are very professional and have both legal and medical training. The investigator will reach out to the licensee by certified letter requesting that the licensee contact the investigator. Once communication with the investigator is made, the investigator will either request that the licensee submit a written statement or submit to an interview.
The interview is the first opportunity a licensee has to respond to the allegations in the complaint. The information given during the interview can shape the direction of the board’s investigation.
Listed below are some typical items you will be questioned about during an interview conducted by an investigator from the Enforcement Division of the Department of Health Professions:
In the Virginia General Assembly, the correct answer to this question is the key to a successful legislative strategy. Considerable thought must be given to this question. Here are a few factors to consider: