Miller v. Huron Reg’l Med. Ctr. Inc. (Summary)

NATIONAL PRACTITIONER DATA BANK

Miller v. Huron Reg’l Med. Ctr. Inc., No. CIV 12-4138 (D. S.D. June 13, 2013)

The United States District Court for the District of South Dakota left pending a physician’s motion to compel a hospital to provide a copy of an external review obtained by the hospital’s insurer that involved the physician’s care of a specific patient, holding that whether the hospital had to provide her with a copy of the review depended upon whether the hospital reported the physician to the National Practitioner Data Bank or took other adverse action on the physician’s appointment or privileges on the basis of the care rendered to that patient.  The court reasoned that if the hospital had filed a report with the NPDB or took other adverse action against the physician in reliance on the external review, she should be provided with a copy of the review in order to satisfy the “fair procedures” portion of the Health Care Quality Improvement Act.  Alternatively, if a report was not made to the NPDB and no other adverse action was taken in reliance on the review, then the hospital did not have to produce the review and the physician would be left to her own resources to subpoena the report.  Interestingly, language in the opinion indicated that the court viewed a report to the NPDB itself to be an adverse action, which could be problematic in cases in which hospitals are required to report surrenders of clinical privileges while under investigation or in order to avoid a professional review action – reporting obligations triggered by the action of the affected physician rather than action by a medical executive committee and/or a board.