Credentialing and Peer Review

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One of the fundamental issues in credentialing disputes is whether the Medical Staff Bylaws constitute contracts between the Hospital and the individual physicians.  If the Medical Staff Bylaws do constitute a contract, then the due process provisions contained in the Bylaws are guaranteed to the physician, regardless of the Health Care Quality Immunity Act (HCQIA).…

Despite the many cases acknowledging the right of hospitals to enter into exclusive contracts, there is always the issue of what happens with the existing clinical privileges and medical staff memberships of the physicians who are being replaced, assuming they are not the physicians receiving the exclusive contract.  Defenders of physician rights have typically argued …

In Fahlen v. Sutter Central Valley Hospitals, the California Supreme Court found:

  1. A physician is not required to first exhaust his administrative remedies through the medical staff appeals process in order to challenge sham peer review as whistleblower retaliation; and
  2. Dr. Fahlen qualified as a whistleblower for purposes of the California Whistleblower Act.

The…

A strange result in Langenberg v. Warren General Hospital, suggests you should pay close attention to the termination language in hospital-physician employment contracts.

Warren General Hospital terminated Dr. Langenberg without cause specifically pursuant to the without cause provisions of his employment contract. Warren General Hospital nonetheless reported the termination as an adverse event to…

Peer Review “Interference” Alleged as Tortious Interference with Contract

Many sham peer review cases are based upon breach of contract in states in which the medical staff bylaws are treated as contracts between the hospital and/or medical staff and the individual physicians. Typically, the cause of actions is based upon some failure to provide the…

Sheikh v. Grant Regional Health Center is another case in a growing body of evidence that courts are granting less leeway and protection to hospitals which abuse the HCQIA immunity and reporting protections.

This is not a final decision awarding damages! It is only a decision by a Wisconsin federal district court rejecting the hospital’s motion…

In Babb v. Centre Community Hospital Geisinger Clinic, and Penn State Geisinger Health System, the Superior Court of Pennsylvania refused to grant the Defendant’s immunity pursuant to the Health Care Quality Improvement Act (HCQIA). 

The standard HCQIA analysis was applied by the Court. Dr. Babb alleged the defendants were biased and motivated by something other than…

The lead report in BNA’s Health Law Reporter on May 31, 2012 noted an increase in lawsuits by doctors claiming that hospital peer review proceedings are being used as retaliation for whistleblower activities, i.e. reports pointing out improper practices and patient safety issues. The report cites two primary reasons for this growing trend:

·         The…

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