The case of Wood v. Archbold Medical Center Inc., presents an interesting twist regarding HCQIA immunity. The holding basically provides that “professional review activity” is a lesser level of adverse activity and need not meet the due process standards of HCQIA in order for a hospital to retain HCQIA.

In Dr. Wood’s situation, there were three “events”: Termination of privileges in 2005, a peer review process in resulting in voluntary relinquishment in 2001, and a mental health evaluation required as a condition of reappointment in 1998.

Dr. Wood asserted that the evaluation was not conducted in accordance with the due process standards of HCQIA and that the hospital should therefore not be immune from antitrust liability. The court concluded that the actions taken in 2004 and 2001 were professional review actions. HCQIA requires professional review actions to meet the due process standards in order to provide HCQIA immunity.

On the other hand, professional review activities is a separately defined term and there is no requirement that professional review activities be conducted in accordance with the due process standards mandated by HCQIA for professional review actions. This new approach to analysis of peer review proceedings presents two tactical options. More commonly, hospitals seek to aggregate all activities into a single “professional review action,” to avoid the situation in which physicians argue that they are entitled to full due process, a hearing, etc., every time there is any peer review activity. Now, rather than aggregating the conduct, it would also be possible under this precedent to argue that some of the actions where in fact activities for which due process was unnecessary.