Changes

...the professional review action was taken

...the professional review action was taken

   

   

1.  in a reasonable belief that the action was in the furtherance of

1.  in a reasonable belief that the action was in the furtherance of quality health care

    quality health care

   

   

2.  after a reasonable effort to obtain the facts of the matter

2.  after a reasonable effort to obtain the facts of the matter

   

   

3.  after adequate notice and hearing procedures are afforded

3.  after adequate notice and hearing procedures are afforded to the physician involved or after such other procedures as are fair to the physician under the circumstances

    to the physician involved or after such other procedures as are fair to the

    physician under the circumstances

   

   

4.  in the reasonable belief that the action was warranted by the facts

4.  in the reasonable belief that the action was warranted by the facts known after such reasonable effort to obtain facts and after meeting the requirements of 3. above.

    known after such reasonable effort to obtain facts and after meeting

    the requirements of 3. above.

   

   

In practice, the "qualified immunity" of HCQIA is converted into nearly absolute immunity for peer reviewers due to a judicial doctrine known as the doctrine of non review or non-intervention.  Courts are very reluctant to "second guess" decisions made in hospitals with respect to peer review.  They frequently defer to the hospital's judgment.  This places physicians who have been wrongfully terminated by a sham peer review at severe disadvantage.

In practice, the "qualified immunity" of HCQIA is converted into nearly absolute immunity for peer reviewers due to a judicial doctrine known as the doctrine of non review or non-intervention.  Courts are very reluctant to "second guess" decisions made in hospitals with respect to peer review.  They frequently defer to the hospital's judgment.  This places physicians who have been wrongfully terminated by a sham peer review at severe disadvantage.

entity (hospital etc.) does not meet the standards delineated in Sec.

entity (hospital etc.) does not meet the standards delineated in Sec.

11111(a)(3) regarding hearing notice and conduct, this in itself does not

11111(a)(3) regarding hearing notice and conduct, this in itself does not

constitute a violation according to 11111(b)(3)(D)(ii).

constitute a violation according to 11111(b)(3)(D)(ii). This basically allows hospitals to do pretty much as they please, and not worry about following due process standards.   

This basically allows hospitals to do pretty much as they please, and not

worry about following due process standards.   

   

   

And, last but not least, so as to strongly discourage physicians who

And, last but not least, so as to strongly discourage physicians who

are victims of an unjust sham peer review, from pursuing justice in

are victims of an unjust sham peer review, from pursuing justice in

the courts, there is a loser pays provision of HCQIA -

the courts, there is a loser pays provision of HCQIA - Sec. 11113.  If the physician does not prevail in the action, the physician can be liable for defendants' legal fees.

Sec. 11113.  If the physician does not prevail in the action, the

physician can be liable for defendants' legal fees.

   

   

Physicians who are strong, outspoken advocates for quality care and

Physicians who are strong, outspoken advocates for quality care and patient safety in hospitals frequently face retaliation by hospitals via sham peer review.  The result of a "successful" bad faith peer review conducted by a hospital is typically the end of the physician's medical career.

patient safety in hospitals frequently face retaliation by hospitals

via sham peer review.  The result of a "successful" bad faith peer

review conducted by a hospital is typically the end of the physician's

medical career.