2014 - Healthcare Quality Improvement Act - Achieving Immunity in Your Peer Review Process

Instructor: William Mack Copeland
Description:
This webinar will discuss the Health Care Quality Improvement Act (HCQIA) in detail, including the standards that must be met to achieve immunity under the act. The Health Care Quality Improvement Act of 1986 is, apparently, meant to save the public from incompetent physicians by permitting those physicians on peer review committees to exchange a few words in an open and honest environment and thus pull out incompetent physicians, without the presence of a retaliatory lawsuit by the reviewed physician. The webinar will also review the HCQIA itself, including a detailed look at the Congressional purpose for the Act. The legislative history of the act will be reviewed to gain an understanding of the intent of Congress in passing the Act.
Next will be a review of the standards under the Act. We will conduct a detailed review of each of the standards and the actions that are required to meet the intent of the standards. Specifically, there are four standards under the Act that must be met. We will review each of these with an eye toward court interpretation of what actions an organization must take to achieve the protections granted by the Act.
First, the action must be taken "in the reasonable belief that the action was in the furtherance of quality health care." We will examine what this means and what is required for the entity taking the action to have a "reasonable belief."
Second, the action must be taken "after a reasonable effort to obtain the facts of the matter." The focus of this portion of the webinar is to review what constitutes an adequate investigation, particularly one that will withstand the scrutiny of the court when the hospital or other professional review body is asking for immunity under the Act.
Third, the action must be taken, "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." We will examine these safe harbor conditions and discuss in detail what must be done to achieve immunity under this standard.
Fourth, the action must be taken, "in the reasonable belief that the action was warranted by the facts known after such reasonable effort to obtain facts and after meeting the [notice and hearing] requirement." We will review that court review and analyze the actions required to meet it.
We will also review cases that discuss the situation where the peer review committee reached incorrect conclusions, and the implications that such a conclusion has for immunity under the Act.
Why Should you Attend:
This webinar will give you an understanding of how the HCQIA protects your organization and those who participate in the peer review process in your organization, as well as to gain an appreciation of the actions that are required to perfect the HCQIA immunity.
The session will discuss what is required to provide a "fair" hearing, including the actions that must be taken before and during the hearing process. You will learn how to facilitate the frank exchange of information among professionals conducting peer review inquiries without the fear of reprisals in civil lawsuits.
Objectives of the Presentation:
To provide the attendee with an understanding of the requirements of the Health Care Quality Improvement Act necessary to obtain immunity under the Act.
Who can Benefit:
Hospital executives, particularly those involved with medical staff activities
Physicians who serve on peer review committees
Medical staff officers
Medical staff support staff
Attorneys representing medical staffs.
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