On October 17, 2007, the American Hospital Association submitted comments to the Joint Commission on revised Medical Staff Standard 1.20.  Unfortunately, the AHA's letter to TJC does not appear to be available at this time. However, it was announced that the AHA's comments stated that revised MS.1.20: (1) could jeopardize quality improvement efforts and create rifts between hospital governance and medical staff; (2) received substantial language changes after field review; (3) would weaken medical executive committees; and (4) overlooks recent trends in medical staffing. The AHA offered to work with The Joint Commission to reconsider language for the standard.

Revised MS.1.20, in short, would require (1) that the medical staff as a whole (rather than the MEC) adopt all Medical Staff Bylaws, Manuals, and policies, (2) there to be process for the medical staff as a whole to override the MEC, and (3) that the Medical Staff Bylaws (not Manuals or other related documents) contain all provisions regarding most medical staff matters (organization, qualifications, privileging, etc.) and permit only “procedural details” on limited topics to be in Manuals or other related documents.

Revised MS.1.20 has generated a great deal of commentary and concern in the industry. Hospitals should remember that revised MS.1.20 does not become effective until July 1, 2009. We have predicted that revised MS.1.20 will not go into effect in its present form. Several versions of this standard have been proposed and rejected over the past five years. As the AHA comments indicate, the industry continues to work to modify the current language of revised MS.1.20. For these reasons, we believe it is premature at this time to make any revisions or changes based on revised MS.1.20. Sit tight -- the fight over MS.1.20 is not finished