Archive for category: Providers

By Kristy M. Kimball

The term “peer review privilege” generally refers to a discovery and evidentiary privilege that can be asserted by hospitals and other healthcare entities to protect the confidentiality of credentialing, quality improvement, and similar peer review activities. While the specific scope, application, and requirements of the peer review privilege vary by state, the underlying purpose is consistent: to foster a protected environment where healthcare professionals and institutions can engage in honest, constructive dialogue and conduct thorough inquiry aimed at improving patient care and clinical performance—without fear that such discussions or findings will be used against them in court.

To gain peer review privilege, healthcare institutions and professionals must ensure that their peer review processes strictly align with the requirements of their state’s peer review privilege laws. Otherwise, in a legal proceeding (e.g., a medical malpractice case involving an underlying incident for which a hospital conducted peer review), a judge may rule that peer review privilege is inapplicable and allow sensitive and unfavorable peer review information and documents to be introduced into evidence.  Accordingly, it is imperative for those involved to clearly understand their state’s peer review privilege laws. Read more

By Kim Stanger

At this time of year, healthcare providers may want to give gifts to patients, referring providers, or other sources of business, but such gifts may violate federal and state fraud and abuse laws and result in civil or criminal fines for both the giver and receiver. Read more