Category Archives: Credentialing and Peer Review

Subscribe to Credentialing and Peer Review RSS Feed

Patient Safety and Quality Improvement Act (PSQIA) May Change Federal Common Law Privilege

In KD v. United States, a decision by the United States District Court for the District of Delaware, both granting and denying a motion for a protective order in parts, indicates that PSQIA of 2005 has changed its opinion regarding the protection of peer review documents under federal common law privilege.  The opinion notes that … Continue Reading

Fundamental Fairness Trumps Technical Violations of Bylaws

In Ramamurthy v. JFK Medical Center and Solaris Health System the Appellate Division of the Superior Court of New Jersey affirmed a summary judgment dismissing Dr. Ramamurthy’s Petition for Injunctive Relief, which sought a court order prohibiting a suspension imposed by the hospital. Dr. Ramamurthy had argued at the trial court level that the hospital had … Continue Reading

Connecticut Supreme Court Reinstates Physician’s Peer Review Damages

The Connecticut Supreme Court issued an interesting decision in the case of Harris v. Bradley Memorial Hospital & Health Center Inc. in May of 2010, which was precipitated by the summary suspension of Dr. Harris. Not only did it overturn the trial court’s grant of judgment notwithstanding the verdict in favor of the hospital, after a … Continue Reading

Discovery of Peer Review Materials

Two recent decisions emphasize the ongoing battle for discovery of peer review information in negligence cases, and confirm that confidentiality is alive and well, but no longer automatic.  In Shell v. Sudan, the United States District Court for the District of Nebraska ordered that deposition questions regarding a hospital risk analysis tool were not precluded … Continue Reading

Medical Staff Bylaws as Contracts

Cases with opposing interpretations on this issue were decided within the past month. Heretofore, the basic question had been whether medical staff bylaws constituted contracts under state law. The majority of courts deciding these cases have concluded that medical staff bylaws were valid contracts. In the states with the opposite holdings, the basic theory was that bylaws merely … Continue Reading

Huron Hospital (Cleveland Clinic) Case Highlights Appropriate Investigation and Discriminatory Treatment Issues

In Badri v. Huron Hospital, which is part of the Cleveland Clinic Health System, the District Court for the Northern District of Ohio granted summary judgment to the defendant hospital in which Dr. Badri was alleging violations of the Americans with Disabilities Act, the Rehabilitation Act, and the typical emotional distress, tortuous interference, defamation and … Continue Reading

Joint Commission Approves MS.01.01.01 effective March 31,2011

NAMSS announces the following: TJC Board of Commissioners Approves MS.01.01.01 Posted: 15 Mar 2010 11:40 AM PDT Chuck Mowll, Executive Vice President of Business Development and Government and External Relations, has announced that The Joint Commissioner’s (TJC) Board of Commissioners has approved the Task Force revision of MS.01.01.01 (formerly MS.1.20) for implementation. MS.01.01.01 will be … Continue Reading

Tennessee Appellate Court Allows Termination of Privileges for Bylaws Violation

In Patterson v. Methodist Health Care-Memphis Hospitals, the Tennessee Court of Appeals affirmed an order of summary judgment, allowing a Tennessee hospital to terminate the medical staff membership and clinical privileges of two physicians for a breach of contract. The contract was established by the medical staff bylaws, which required a certain level of continuous uninterrupted … Continue Reading

Hospital Uses After-Acquired Evidence to Support Summary Suspension of Physician

Dr. Gary Ritten was a medical staff member at Lapeer Regional Medical Center in Indiana. He was summarily suspended in September 2005, allegedly in retaliation for refusing to transfer a patient who had not been stabilized as required by EMTALA. The suspension was initially rescinded by the Medical Executive Committee, although it was reinstated by the hospital’s … Continue Reading

New Data Bank Regulations Implement Social Security Act §1921 – MMPPA §5(h)

  New Data Bank Regulations Implement Social Security Act §1921 – MMPPA §5(h) The Medicare and Medicaid Program Protection Act (MMPPA) added Soc. Sec. §1921. This law expanded state licensure reporting obligations to match those already in place for the Healthcare Integrity and Protection Data Bank (HIPDB), which became active in 1999. These regulations will make reporting … Continue Reading

HCQIA Immunity: Perfect Investigations and Furthering Self-Quality Health Care

The case of Cowell v. Good Samaritan Community Health Care, a state court case in Washington, provides guidance on two of the four elements of HCQIA immunity, i.e. that the action was reasonably taken in the furtherance of quality health care and the necessary substance to establish a reasonable investigation.  Dr. Cowell raised an unusual … Continue Reading

Hospital Bears Burden of Proving Peer Review Privilege

In Bansal vs. Mount Carmel Health Systems, Inc., an Ohio state appellate court ruled that the hospital had failed to prove that documents were protected by Ohio’s statutory peer review privilege (Ohio Rev. Code § 2305.25), and reversed a trial court summary judgment decision. Dr. Girraj K. Bansal was removed from the hospital’s call schedule, and then brought … Continue Reading

Peer Review Confidentiality Impacted by Forum Shopping

In Kentucky, common law president permits discovery of peer review documents. Ohio Rev. Code § 2305.252 protects peer review discovery. In Saleba v. Schrand, the estate of a Kentucky resident sued an Ohio physician and Good Samaritan Hospital, located in Cincinnati, Ohio, in Kentucky based upon the results of medical services performed in Ohio. The Kentucky Supreme … Continue Reading

Montana Physician Obtains Injunction Preventing National Practitioner Data Bank Report

The Montana Supreme Court held in John Doe, M.D. v. Community Medical Center that the Health Care Quality Improvement Act (HCQIA) does not preempt state law regarding injunction and breach of contract, thereby allowing the lower court to issue an injunction against Community Medical Center prohibiting it from issuing a Data Bank report regarding the … Continue Reading

Ad Hoc Medical Staff Committees Protected by HCQIA

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 … Continue Reading

Fourth Circuit Decision Identifies Importance of State Peer Review Immunity Statutes

In Isaiah v. WMHS Braddock Hospital Corporation and Memorial Hospital and Medical Center of Cumberland, the Fourth Circuit affirmed an order granting summary judgment against Dr. Isaiah in favor of WMHS Braddock Hospital on the basis that summary judgment was appropriate under both HCQIA and the Maryland statutes providing immunity for peer review activity (Md. … Continue Reading

State Courts Continue to Limit Confidentiality of Peer Review Records

The Massachusetts Supreme Court ruled in Board of Registration in Medicine v. Hallmark Health Corp. that the Massachusetts licensing board would subpoena certain hospitals peer review records.  In Director of Health Affairs Policy Planning, University of Connecticut v. Freedom of Information Commission, the Connecticut Supreme Court ruled that the state’s freedom of information act contradicted … Continue Reading

Georgia Supreme Court Rules Peer Review Information Not Always Confidential

In Hospital Authority of Valdosta and Lowndes County v. Meeks, the Georgia Supreme Court ruled that information contained in a physician’s peer review file was not necessarily protected by the Georgia Peer Review Confidentiality Statute. Although the holding is enticing from the physician perspective, the limitations contained in the opinion render the precedent potentially meaningless. The … Continue Reading

HCQIA Case Denies Defense Request for Attorney’s Fees

Stratienko v. Chattanooga-Hamilton County Hospital Authority, has produced yet another important opinion from the HCQIA prospective. In its most recent ruling, the United States District Court for the Eastern District of Tennessee has dismissed a claim by physicians, named as defendants in the litigation arising out of Dr Stratienko’s suspension, to recover attorney’s fees against Dr. … Continue Reading

Must Hospitals Provide Credentialing Information for Physicians?

  Is there a duty for a hospital to answer a credentialing inquiry from another institution? A hospital’s refusal to answer an inquiry presumably has the same impact as an employer’s refusal to answer a request for references: when the inquiring party receives no response, they presume, and usually rightly so, that the party to whom … Continue Reading

HCQIA Immunity Requires Due Process

In Hussein vs. Duncan Regional Hospital, United States District Court for the Western District of Oklahoma denied immunity under the Health Care Quality Improvement Act (HCQIA) to Duncan Regional Hospital because it terminated a physician’s privileges and reported him to the National Practitioners Data Bank (NPDB) without providing notice or an opportunity to be heard.  … Continue Reading

Tennessee State Law Immunizes Neglegant Credentialing

Most participants in the credentialing process are familiar with state statutes providing peer review immunity and confidentiality. The Tennessee statute analyzed in Smith v. Pratt and HCA Health Services of Tennessee, Inc. /d/b/a CentennialMedicalCenter take that immunity one step further.  In this malpractice case, the court held that Tennessee Code § 63-6-219 provides immunity for negligent … Continue Reading