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

OVERVIEW

This quality management training 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 HCQIA itself will be reviewed, 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.

WHY SHOULD YOU ATTEND

You should attend this webinar to gain an understanding of how the HCQIA protects your organization and those who participate in the peer review process in your organization, as well as gain an appreciation of the actions that are required to perfect the HCQIA immunity. Failure to take the appropriate actions and to follow the correct protocol can result in a disastrous situation.

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. The statute attempts to balance the chilling effect of litigation on peer review with concerns for protecting physicians improperly subjected to disciplinary action; accordingly, Congress granted immunity from monetary damages to participants in properly conducted peer review proceedings while preserving causes of action for injunctive or declaratory relief for aggrieved physicians. Not only will you gain an understanding of the immunity provisions, you will gain an appreciation of the standards that professional review actions must satisfy to entitle the participants to such protection.

AREAS COVERED

• The Health Care Quality Improvement Act
• Legislative history of the Health Care Quality Improvement Act and the intent of Congress Immunity under the Health Care Quality Improvement Act
• Standards required achieving immunity under the Health Care Quality Improvement Act Review of the Health Care Quality Improvement Act by the courts

WHO WILL BENEFIT

Hospital executives, medical staff officers, physicians who serve on peer review committees, medical staff support staff, and attorneys representing medical staffs.

LEARNING OBJECTIVES

We 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 gain an understanding of how to conduct an investigation of the allegations that form the basis of the action and the standards that the courts review to ensure that the investigation was adequate. You will learn how the courts interpret the mandate in the HCQIA that the action was taken “in the reasonable belief that the action was in the furtherance of quality health care.” You will also gain an understanding of what is required to meet the standard, “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.”

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