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Title 42 — The Public Health and Welfare

Chapter 117 — Encouraging Good Faith Professional Review Activities

§ 11133. Reporting of certain professional review actions taken by health care entities

Statutory text

(a)

Reporting by health care entities

(1)

On physicians

Each health care entity which—

(A)

takes a professional review action that adversely affects the clinical privileges of a physician for a period longer than 30 days;

(B)

accepts the surrender of clinical privileges of a physician—

(i)

while the physician is under an investigation by the entity relating to possible incompetence or improper professional conduct, or

(ii)

in return for not conducting such an investigation or proceeding; or

(C)

in the case of such an entity which is a professional society, takes a professional review action which adversely affects the membership of a physician in the society,

shall report to the Board of Medical Examiners, in accordance with section 11134(a) of this title, the information described in paragraph (3).

(2)

Permissive reporting on other licensed health care practitioners

A health care entity may report to the Board of Medical Examiners, in accordance with section 11134(a) of this title, the information described in paragraph (3) in the case of a licensed health care practitioner who is not a physician, if the entity would be required to report such information under paragraph (1) with respect to the practitioner if the practitioner were a physician.

(3)

Information to be reported

The information to be reported under this subsection is—

(A)

the name of the physician or practitioner involved,

(B)

a description of the acts or omissions or other reasons for the action or, if known, for the surrender, and

(C)

such other information respecting the circumstances of the action or surrender as the Secretary deems appropriate.

(b)

Reporting by Board of Medical Examiners

Each Board of Medical Examiners shall report, in accordance with section 11134 of this title, the information reported to it under subsection (a) and known instances of a health care entity’s failure to report information under subsection (a)(1).

(c)

Sanctions

(1)

Health care entities

A health care entity that fails substantially to meet the requirement of subsection (a)(1) shall lose the protections of section 11111(a)(1) of this title if the Secretary publishes the name of the entity under section 11111(b) of this title.

(2)

Board of Medical Examiners

If, after notice of noncompliance and providing an opportunity to correct noncompliance, the Secretary determines that a Board of Medical Examiners has failed to report information in accordance with subsection (b), the Secretary shall designate another qualified entity for the reporting of information under subsection (b).

(d)

References to Board of Medical Examiners

Any reference in this subchapter to a Board of Medical Examiners includes, in the case of a Board in a State that fails to meet the reporting requirements of section 11132(a) of this title or subsection (b), a reference to such other qualified entity as the Secretary designates.

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

  1. Health Care Quality Improvement Act of 1986

    Pub. L. 99–660 title IV § 423 · 100 Stat. 3743

    Enacted · 42 U.S.C. § 11133

    (Pub. L. 99–660, title IV, § 423, Nov. 14, 1986, 100 Stat. 3789.)

    Source evidence

    Code source credit
    (Pub. L. 99–660, title IV, § 423, Nov. 14, 1986, 100 Stat. 3789.)

    Enacted provision · exact public law section
    SEC. 423. REPORTING OF CERTAIN PROFESSIONAL REVIEW ACTIONS TAKEN BY HEALTH CARE ENTITIES. (a) Reporting by Health Care Entities.— (1) On physicians.— Each health care entity which— (A) takes a professional review action that adversely affects the clinical privileges of a physician for a period longer than 30 days; (B) accepts the surrender of clinical privileges of a physician— (i) while the physician is under an investigation by the entity relating to possible incompetence or improper professional conduct, or (ii) in return for not conducting such an investigation or proceeding; or (C) in the case of such an entity which is a professional society, takes a professional review action which adversely affects the membership of a physician in the society, shall report to the Board of Medical Examiners, in accordance with section 424(a), the information described in paragraph (3). (2) Permissive reporting on other licensed health care practitioners.— A health care entity may report to the Board of Medical Examiners, in accordance with section 424(a), the information described in paragraph (3) in the case of a licensed health care practitioner who is not a physician, if the entity would be required to report such information under paragraph (1) with respect to the practitioner if the practitioner were a physician. (3) Information to be reported.— The information to be reported under this subsection is— (A) the name of the physician or practitioner involved, (B) a description of the acts or omissions or other reasons for the action or, if known, for the surrender, and (C) such other information respecting the circumstances of the action or surrender as the Secretary deems appropriate. (b) Reporting by Board of Medical Examiners.— Each Board of Medical Examiners shall report, in accordance with section 424, the information reported to it under subsection (a) and known instances of a health care entity’s failure to report information under subsection (a)(1). (c) Sanctions.— (1) Health care entities.— A health care entity that fails substantially to meet the requirement of subsection (a)(1) shall lose the protections of section 411(a)(1) if the Secretary publishes the name of the entity under section 411(b). (2) Board of medical examiners.— If, after notice of non-compliance and providing an opportunity to correct noncompliance, the Secretary determines that a Board of Medical Examiners has failed to report information in accordance with subsection (b), the Secretary shall designate another qualified entity for the reporting of information under subsection (b). (d) State and local governments. References to Board of Medical Examiners.— Any reference in this part to a Board of Medical Examiners includes, in the case of a Board in a State that fails to meet the reporting requirements of section 422(a) or subsection (b), a reference to such other qualified entity as the Secretary designates.

1 of 1 references resolved to an enrolled provision

Credits

(Pub. L. 99–660, title IV, § 423, , 100 Stat. 3789.)

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