Health Care Law Alert

Hospital Reporting of Disciplinary Actions in Pennsylvania, New Jersey and Maryland

Thursday, May 29, 2008

According to a recent report released by the Federation of State Medical Boards, the number of disciplinary actions taken against physicians by state medical boards has reduced for the second straight year. The group’s Annual Summary of Board Actions shows fewer serious disciplinary actions (including suspensions, probations and privileges revocations) last year despite an increase in the number of physicians practicing nationwide. Using the findings of this report, Public Citizen, a nonprofit consumer advocacy organization, ranked each state’s medical board according to their disciplinary rates. Pennsylvania (38), New Jersey (42) and Maryland (43) had among the lowest disciplinary rates.

Rates and Rankings of the State Medical Boards’ Serious Disciplinary Actions, 2007
State (Ranking)	Number of Serious Actions, 2007	Number of Physicians, 2006	Serious Actions per 1,000 Physicians, 2005-2007
1. Alaska	19	1,832	8.33
2. Kentucky	83	11,251	6.55
38. Pennsylvania	118	42,204	2.70
42. New Jersey	79	33,103	2.32
43. Maryland	56	26,623	2.26

According to the Public Citizen report, among the factors affecting a medical board’s ability to discipline physicians is whether the board has complete access to reliable data concerning hospital disciplinary measures. That access, in turn, may depend on whether the hospitals are actually reporting these disciplinary measures, as required by law. A closer look at the reporting requirements of Pennsylvania, New Jersey and Maryland may be necessary.

Pennsylvania Institutional Reporting Requirements

Section 48.806a of the Pennsylvania Health Care Facilities Act requires health care facilities and hospitals, upon “reasonable cause to believe malpractice or misconduct has occurred,” to report to the State Board of Medical Education and Licensure the occurrence of:

• the termination or curtailment of the employment, association or professional privileges of a licensed physician;
• the resignation or withdrawal of association or of privileges with a facility or hospital to avoid the imposition of disciplinary measures; or
• the receipt of written information which establishes that any physician who has a right to practice or who has applied to practice at the health care facility or hospital has been convicted of a felony.

New Jersey Institutional Reporting Requirements

Under N.J.S.A. §26:2H-12.2 and N.J.A.C. §8:43A-3.10, health care facilities and health maintenance organizations are required to notify the New Jersey Medical Practitioner Review Panel in writing if, for reasons relating to “impairment, incompetency or professional misconduct, which incompetency or professional misconduct relates adversely to patient care or safety,” a health care professional:

• has full or partial privileges summarily or temporarily revoked or suspended, or permanently reduced, suspended or revoked;
• has had a contract to render professional services terminated or rescinded;
• has conditions or limitations placed on the exercise of clinical privileges or practice within the health care entity; or
• voluntarily resigns from the staff if: (a) the health care entity is reviewing the health care professional’s patient care or reviewing whether, based upon its reasonable belief, the health care professional’s conduct demonstrates an impairment or incompetence or is unprofessional, which incompetence or unprofessional conduct relates adversely to patient care or safety; or (b) the health care entity, through any member of the medical or administrative staff, has expressed an intention to do such a review.

Maryland Institutional Reporting Requirements

Under §14-413 of the Maryland Health Occupations Code, a hospital or related institution must report to the Maryland Board of Physicians if, for reasons relating to competence, performance, unprofessional practices and unethical practices, any of the following events occur:

• the hospital or related institution denied the application of a physician for staff privileges or limited, reduced, otherwise changed, or terminated the staff privileges of a physician, or the physician resigned whether or not under formal accusation
• the hospital or related institution took any disciplinary action against a salaried, licensed physician without staff privileges, including termination of employment, suspension or probation
• the hospital or related institution took any disciplinary action against an individual in a postgraduate medical training program, including removal from the training program, suspension or probation
• a licensed physician or an individual in a postgraduate training program voluntarily resigned from the staff, employ or training program of the hospital or related institution
• the hospital or related institution placed any other restrictions or conditions on any of the licensed physicians.

Each of the regulations provides the reporting hospital with immunity from any civil or criminal liability which may arise in connection with the hospital’s making such reports in good faith. However, hospitals that fail to provide such notice to the appropriate medical board or that fail to cooperate with a request for such information may be subject to penalties.

A copy of the Federation of State Medical Boards report is available at http://www.fsmb.org/pdf/States_2008.pdf.

Andrew J. Siegel

Written by

The material in this publication is based on laws, court decisions, administrative rulings and congressional materials, and should not be construed as legal advice or legal opinions on specific facts. The information in this publication is not intended to create, and the transmission and receipt of it does not constitute, a lawyer-client relationship.

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