§11137 — Title 42 The Public Health and Welfare | U.S. Code

Summary

The Secretary (or the agency the Secretary names) must give information reported about a doctor or other licensed health worker to State licensing boards, hospitals, and other health care groups (including HMOs) that ask because they are hiring, affiliating with, or deciding on clinical privileges or medical staff membership. The information is private and must not be shared except to the doctor or worker involved, for professional review or related quality activities as allowed by the Secretary’s rules, or when state law otherwise lets someone share it. Non-identifying, anonymous data is not private, and the Secretary must make and give that kind of summary on request. The Secretary can charge a reasonable fee that only covers processing costs. Anyone who shares the information wrongfully can be fined up to $10,000 for each violation. No person or group can be sued for making a report under these rules unless they knew the report was false. A payment to settle a medical malpractice claim does not by itself prove that malpractice happened.

Title 42, §11137

The Public Health and Welfare — Source: USLM XML via OLRC

(a)The Secretary (or the agency designated under section 11134(b) of this title) shall, upon request, provide information reported under this subchapter with respect to a physician or other licensed health care practitioner to State licensing boards, to hospitals, and to other health care entities (including health maintenance organizations) that have entered (or may be entering) into an employment or affiliation relationship with the physician or practitioner or to which the physician or practitioner has applied for clinical privileges or appointment to the medical staff.

(b)(1)Information reported under this subchapter is considered confidential and shall not be disclosed (other than to the physician or practitioner involved) except with respect to professional review activity, as necessary to carry out subsections (b) and (c) of section 11135 of this title (as specified in regulations by the Secretary), or in accordance with regulations of the Secretary promulgated pursuant to subsection (a). Nothing in this subsection shall prevent the disclosure of such information by a party which is otherwise authorized, under applicable State law, to make such disclosure. Information reported under this subchapter that is in a form that does not permit the identification of any particular health care entity, physician, other health care practitioner, or patient shall not be considered confidential. The Secretary (or the agency designated under section 11134(b) of this title), on application by any person, shall prepare such information in such form and shall disclose such information in such form.

(2)Any person who violates paragraph (1) shall be subject to a civil money penalty of not more than $10,000 for each such violation involved. Such penalty shall be imposed and collected in the same manner as civil money penalties under subsection (a) of section 1320a–7a of this title are imposed and collected under that section.

(3)Subject to paragraph (1), information provided under section 11135 of this title and subsection (a) is intended to be used solely with respect to activities in the furtherance of the quality of health care.

(4)The Secretary may establish or approve reasonable fees for the disclosure of information under this section or section 11136 of this title. The amount of such a fee may not exceed the costs of processing the requests for disclosure and of providing such information. Such fees shall be available to the Secretary (or, in the Secretary’s discretion, to the agency designated under section 11134(b) of this title) to cover such costs.

(c)No person or entity (including the agency designated under section 11134(b) of this title) shall be held liable in any civil action with respect to any report made under this subchapter (including information provided under subsection (a) 11 So in original. Probably should be followed by another closing parenthesis. without knowledge of the falsity of the information contained in the report.

(d)In interpreting information reported under this subchapter, a payment in settlement of a medical malpractice action or claim shall not be construed as creating a presumption that medical malpractice has occurred.

Notes & Related Subsidiaries

Editorial Notes

Amendments

1987—Subsec. (b)(1). Pub. L. 100–177, § 402(a)(1), substituted “as necessary to carry out subsections (b) and (c) of section 11135 of this title (as specified in

Regulations

by the Secretary)” for “with respect to medical malpractice actions” and inserted at end “Information reported under this subchapter that is in a form that does not permit the identification of any particular health care entity, physician, other health care practitioner, or patient shall not be considered confidential. The Secretary (or the agency designated under section 11134(b) of this title), on application by any person, shall prepare such information in such form and shall disclose such information in such form.” Subsec. (b)(4). Pub. L. 100–177, § 402(b), added par. (4). Subsec. (c). Pub. L. 100–177, § 402(a)(2), inserted “(including the agency designated under section 11134(b) of this title)” after “entity” and “(including information provided under subsection (a)” after “subchapter”.

Statutory Notes and Related Subsidiaries

Effective Date

of 1987 Amendment Pub. L. 100–177, title IV, § 402(d), formerly § 402(c), Dec. 1, 1987, 101 Stat. 1007, as renumbered and amended by Pub. L. 101–239, title VI, § 6103(e)(6), Dec. 19, 1989, 103 Stat. 2208, provided that: “(1) In general.—The

Amendments

made by subsections (a) and (c) [amending this section and section 1111 and 1115 of this title] shall become effective on November 14, 1986. “(2) Fees.—The amendment made by subsection (b) [amending this section] shall become effective on the date of enactment of this Act [Dec. 1, 1987].”

§11137 Miscellaneous Provisions

Summary

Title 42, §11137

Notes & Related Subsidiaries

Editorial Notes

Amendments

Regulations

Statutory Notes and Related Subsidiaries

Effective Date

Amendments

Citations & Metadata