§11133 Reporting of Certain Professional Review Actions Taken by Health Care Entities

Summary

Health care entities must tell the state medical board when they take certain actions against a doctor. They must report if they cut or limit a doctor’s clinical privileges for more than 30 days, accept a doctor’s surrender of privileges while the doctor is under investigation or in exchange for not investigating, or a professional society limits a doctor’s membership. They may also report similar actions about other licensed health practitioners if the same rules would apply to a doctor. The report must give the person’s name, explain the reason or behavior that led to the action or surrender, and any other details the Secretary asks for. State medical boards must pass those reports along and tell about known cases where an entity failed to report. If an entity fails to report, it can lose the legal protections in section 11111(a)(1) if the Secretary publishes the entity’s name under section 11111(b). If a board fails to report after notice and a chance to fix the problem, the Secretary will pick another qualified entity to do the reporting. When a State board does not meet the reporting rules, the Secretary’s chosen entity stands in for the board.