The General Medical Council is to review an investigation into a senior executive at NHS England, Dame Barbara Hakin.
She has faced claims she endangered patients by ordering a hospital trust to meet performance targets whatever the cost, while she was head of the East Midlands Strategic Health Authority.
Dame Barbara, now national director for commissioning operations, was cleared by the GMC in 2013 after an investigation.
But that will now be reviewed.
Allegations of bullying and endangering patient safety had dogged Dame Barbara since 2009, when she ran the East Midlands authority.
They relate in particular to the treatment of the former chief executive of United Lincolnshire Hospitals turned whistleblower, Gary Walker, who lost his job after being told waiting time targets had to be met despite his concerns over patient safety.
A year-long GMC investigation cleared Dame Barbara of 17 separate allegations in 2013, all of which she had denied.
That investigation is now being reviewed, but the GMC says Dame Barbara is not facing a fresh inquiry.
Documents seen by the BBC suggest the decision may "in part be materially flawed" - including concerns that the evidence gathered did not go far enough in relation to the allegations around patient safety - and say a review is in the public interest.
A General Medical Council spokesperson said: "We don't comment in detail on individual doctors. But we can confirm that Dame Barbara Hakin is not under investigation by the GMC.
"We are however reviewing a decision made as part of our original investigation. This process, known as Rule 12, enables the GMC in certain circumstances to review a decision previously made."
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