In Feller v. Miriam Hospital, the Rhode Island Superior Court provides additional guidance regarding immunity protection pursuant to the Health Care Quality Improvement Act (HCQIA). 

In that case, Dr. Joseph Feller was practicing at Miriam Hospital in Rhode Island. He encountered some disciplinary issues in 2002 and agreed to both monitoring by a hospital appointed panel (Peer Review Panel) and that such panel could institute future adverse credentialing actions (including the termination of his medical staff privileges) without the right of appeal pursuant to the medical staff bylaws. When Dr. Feller encountered additional problems in 2007, the Peer Review Panel investigated the issues and unanimously decided to terminate his privileges.

There were a variety of issues decided by the Rhode Island Superior Court, and the following two provides specific guidance in the HCQIA area.

First, the Rhode Island Court decided that an ad hoc panel was a “professional review body” as defined by HCQIA, in which the definition states “Any committee of a health care entity which conducts professional review activity,” and the definition of professional review activity included the actions taken by the Peer Review Panel. 

Second, the Court decided that physicians could waive provisions of HCQIA by specific agreement, and that HCQIA immunity would still be available if the four elements of HCQIA immunity were present, or were specifically waived by the physician. In this case, Dr. Feller waived his due process and appeal rights by specific consent agreement, which the Court found to be valid. The Court concluded that the provision allowing due process procedures that were “otherwise fair” obviously protected consent agreements of the type entered into by Miriam Hospital and Dr. Feller.