Document Type
Article
Publication Date
2015
Abstract
This Article examines the procedural due process protections afforded to physicians under the Health Care Quality Improvement Act of 1986 (HCQIA), focusing on the statutory requirement of “adequate notice and hearing” in professional peer review proceedings. Although HCQIA was enacted to promote effective peer review and improve the quality of medical care by granting immunity to hospitals and review bodies, the statute conditions immunity on compliance with certain fairness standards. The Article identifies a doctrinal gap between the statute’s safe harbor provisions and the broader, undefined requirement of adequacy, noting that courts frequently resolve immunity questions at summary judgment under a presumption favoring hospitals. Moreover, because HCQIA provides no independent cause of action for physicians, challenges to deficient procedures arise only defensively, further limiting meaningful judicial scrutiny. Surveying federal circuit court decisions, the Article demonstrates that courts have struggled to articulate a consistent standard for adequacy and often treat immunity as a legal question insulated from jury review. To resolve this ambiguity, the Article proposes using the balancing framework articulated in Mathews v. Eldridge as a coherent analytical standard for evaluating whether private hospital peer review procedures satisfy HCQIA’s due process requirements. By importing the Mathews test, courts could better balance the statute’s dual goals of encouraging candid peer review and protecting physicians from arbitrary or procedurally deficient disciplinary actions.
Recommended Citation
Amy L. Moore, The Due Process Conundrum: Using Mathews v. Eldridge as a Standard for Private Hospitals under the Health Care Quality Improvement Act, 2 Belmont L. Rev. 1 (2015).
