Definitions

Checkout our iOS App for a better way to browser and research.

As used in this subchapter:

  1. (1) “Adversely affect”, when used in reference to clinical privileges or medical staff membership, means deny, reduce, restrict, suspend, revoke, or fail to renew;

  2. (2) “Conflict of interest” means a personal or financial interest that would lead an objective person to conclude that it would be difficult for the person in those circumstances to make a fair and impartial decision in a professional review activity with regard to a particular physician;

  3. (3) “Hospital” means a healthcare facility licensed as a hospital by the Division of Health Facilities Services under § 20-9-213;

  4. (4)

    1. (A) “Investigation” means a process conducted by a professional review body to:

      1. (i) Obtain and make a detailed examination of the facts related to an identified concern about a specific physician; and

      2. (ii) Determine whether a professional review action should be requested or recommended.

    2. (B) “Investigation” does not include the following:

      1. (i) A preliminary review to obtain basic information related to a concern or complaint about a physician in order to determine whether an investigation should commence;

      2. (ii) Routine quality assurance, case review, utilization review, and performance improvement activities that take place within a hospital; or

      3. (iii) Collegial interventions, ongoing physician practice evaluations and focused physician practice evaluations, and other peer-to-peer performance improvement interventions that are not intended to, and do not, impact a physician's clinical privileges or hospital medical staff membership;

  5. (5) “Medical staff” means the physicians who are approved and given privileges to provide health care to patients in the hospital;

  6. (6) “Professional review action” means an action or recommendation of a professional review body that is taken or made in the conduct of professional review activity and that:

    1. (A) Is based on an individual physician's competence or professional conduct that adversely affects or could adversely affect the health or welfare of a patient or patients; and

    2. (B) Adversely affects or may adversely affect the medical staff membership or clinical privileges of the physician;

  7. (7)

    1. (A) “Professional review activity” means an activity with respect to an individual physician:

      1. (i) To determine whether the physician may have clinical privileges at a hospital or membership on the hospital's medical staff;

      2. (ii) To determine the scope or conditions of clinical privileges or medical staff membership; or

      3. (iii) To change or modify such clinical privileges or medical staff membership.

    2. (B) “Professional review activity” includes an investigation, as defined in this section; and

  8. (8) “Professional review body” means a hospital, its governing body, or its medical staff when any of these bodies are conducting a professional review activity.


Download our app to see the most-to-date content.