by Kim Stanger

Idaho has enacted a broad privilege that protects the confidentiality of credentialing, quality improvement, and similar peer review activities by Idaho hospitals and other health care entities. The statute encourages participation and protects the integrity of such peer review activities by ensuring that peer review communications and proceedings remain confidential, and that participants are immune from liability.

Application. The privilege applies to “peer review” activities conducted by “healthcare organizations”. (I.C. § 39-1392).

“Health care organization” means a hospital, in-hospital medical staff committee,¹ medical society, managed care organization, licensed emergency medical service, group medical practice, or skilled nursing facility.

(I.C. § 39-1392a(3)).

“Peer review” means the collection, interpretation and analysis of data by a health care organization for the purpose of bettering the system of delivery of health care or to improve the provision of health care or to otherwise reduce patient morbidity and mortality and improve the quality of patient care. Peer review activities by a health care organization include, without limitation:
(a) Credentialing, privileging or affiliating of health care providers as members of, or providers for, a health care organization;
(b) Quality assurance and improvement, patient safety investigations and analysis, patient adverse outcome reviews, and root-cause analysis and investigation activities by a health care organization; and
(c) Professional review action, meaning an action or recommendation of a health care organization which is taken or made in the conduct of peer review, that is based on the competence or professional conduct of an individual physician or emergency medical services personnel where such conduct adversely affects or could adversely affect the health or welfare of a patient or the physician’s privileges, employment or membership in the health care organization or in the case of emergency medical services personnel, the emergency medical services personnel’s scope of practice, employment or membership in the health care organization.

(I.C. § 39-1392a(11)). Continue reading →

by Kelly McIntosh

Marking the first update since September 2001, the Health Resources and Services Administration (“HRSA”) division of the Department of Health and Human Services (“HHS”) has issued a draft of the revised National Practitioner Data Bank (“NPDB”) Guidebook. The release of the draft Guidebook was announced in the Federal Register on December 27, 2013 and the period to submit comments to the draft is ongoing until January 31, 2014.

The revised Guidebook includes expanded and improved examples about reporting to and querying the NPDB, live links to cited statutes and regulations, and useful tables explaining NPDB policies. Also incorporated in the revised Guidebook are legislative and regulatory changes adopted since the last edition. Perhaps the most significant regulatory change incorporated in the revised Guidebook is the merger of the NPDB and the Healthcare Integrity and Protection Data Bank (“HIPDB”) which occurred on May 6, 2013 pursuant to the Patient Protection and Affordable Care Act (“ACA”).

The revised Guidebook also expands on certain areas where there has previously been uncertainty, including when an “investigation” by a health care entity has commenced. On that topic, the revised Guidebook includes additional details and examples regarding when an investigation has commenced. Specifically, the draft Guidebook provides that “an investigation is not limited to a health care entity’s gathering of facts. An investigation begins as soon as the health care entity begins an inquiry and does not end until the health care entity’s decisionmaking authority takes a final action or formally closes the investigation.” Continue reading →