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Credentialing and peer review disclosure in lawsuits

Credentialing Resource Center Connection, February 19, 2009

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Anne R. Buss, CPMSM, CPCS, is a medical staff consultant based in Fayetteville, AR.

Dear credentialing colleague,

I read this past week that the United States District Court for the Northern District of Oklahoma ruled that all peer review and/or credentialing files be produced during a lawsuit. While this is not the first instance of a court ruling where the peer review privilege does not apply, it does add to the number of cases where it has been determined that  the need to enforce federal antitrust law in this context outweighs excluding these relevant pieces of evidence from discovery. 

Peer review has long been proposed as critical to improving patient care. Thus, we have the federal Health Care Quality Improvement Act (HCQIA) and the Patient Safety and Quality and Improvement Act of 2005 (PSQIA). Questions about peer review are not likely to go away any time soon, and they might even increase as patient care continues to diversify with growing specialty centers and other care outlets. 

Policies and procedures relating to the production and use of peer review and quality data should be reviewed by hospital legal counsel annually, so that changes in applicable laws can be can be implemented to offer maximum protection. 

Remember, those who are afraid to ask are afraid to learn.

All the best,
Anne R. Buss, CPMSM, CPCS

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