The Health Care Quality Improvement Act (HCQIA), 42 U.S.C.A. §11101 et seq., is a federal law that has, inter alia, a goal of fostering meaningful peer review within health care entities, without participants having a fear of legal action based upon their participation. In accordance with this goal, HCQIA provides statutory immunity from damages to professional review bodies and certain others associated with it, as long as they comply with the HCQIA.
With the many positives of the HCQIA, there are certain negatives. For example, individual physicians who are the subject matter of peer review actions and suffer adverse consequences arising out of those proceedings may find themselves without any legal redress. One must bear in mind that often, when an adverse result occurs to a physician stemming out of a peer review action, such as a loss of medical staff privileges, there may be collateral consequences including but not limited to a report to the National Practitioner Databank (NPDB) that will be published to the physician’s state licensing authority, other hospitals where the physician has privileges and to all the insurance companies with which the physician practices. These other entities may then take action against the physician. In a worst-case scenario, a physician may find him or herself without a medical career and no legal redress.
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