The Health Care Quality Improvement Act and the National Practitioner Databank: Constitutional Violations and Preservation of Civil Rights for Physicians

¹University of Central Florida College of Medicine, Orlando, Florida, USA

²Mercy Health, Paducah, Kentucky, USA

³State University of New York (SUNY), Brooklyn, New York, USA

*Corresponding author: Farid Gharagozloo, MD, FACHE, Institute for Advanced Thoracic Surgery, 6718 lake Nona Blvd., Orlando Florida 32827, USA; E-mail: [email protected]

Received Date: February 22, 2023

Published Date: March 07, 2023

Citation: Gharagozloo F, et al. (2023). The Health Care Quality Improvement Act and the National Practitioner Databank: Constitutional Violations and Preservation of Civil Rights for Physicians. Mathews J Case Rep. 8(3):93.

Copyrights: Gharagozloo F, et al. © (2023).

ABSTRACT

In 1986, the US Congress passed the Health Care Quality Improvement Act (HCQIA). This law was designed to protect the health and safety of the public by 1) enhancing the Peer Review process through protection for peer review members from lawsuits, and 2) providing a national repository (National Practitioner Data Bank, NPDB) for reported information regarding medical malpractice payments and adverse actions involving physicians. Since then, the NPDB also monitors information on physicians that are deemed incompetent or unprofessional by their employers, for both rightful and wrongful (“sham peer review”) reasons. The HCQIA framers in 1986 could not foresee that in 2023, hospitals and other healthcare employers would invariably deny employment and/or hospital privileges based on an NPDB report outlining the loss of hospital privileges or relinquishment of hospital privileges under investigation. Such an adverse report by NPDB results in the inability of the physician to obtain employment or practice in a hospital. Hence, the unintended consequence of reporting adverse peer review actions by NPDB, an agency of the Federal Government, violates the constitutional and civil rights of said physicians. The NPDB reporting provision of HCQIA appears to violate a number of amendments, specifically the 5th, 8th, 9^th, and 10th amendments of the Constitution.

In the 1980’s an increasing number of lawsuits were brought against peer review groups by physicians whose privileges had been restricted by hospitals, medical societies, and state medical licensing boards. Pecularly, the American Medical Association (AMA) argued that the lawsuits against peer review groups had a “chilling effect” on the existentially vital peer review process. In response to these concerns, the US Congress passed the Health Care Quality Improvement Act of 1986 (HCQIA), signed into effect on November 14, 1986 and became fully operational on September 1, 1990. HCQIA was designed to protect the health and safety of the public by 1) enhancing the Peer Review process through protection for peer review members from lawsuits, and 2) providing a national repository for reported information regarding medical malpractice payments and adverse actions involving physicians, which among other things, would monitor the movement of incompetent or unprofessional physicians [1].