Regulatory Issue in Institutional Health Care It Essay

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Regulatory Issue in Institutional Health Care

It is reported that a medical doctor licensed to practice in Florida, Zoher, applied for a staff position at Naples Community Hospital (NCH) which is a facility operated by defendant NCH Healthcare System Inc. (NCHS). The board of trustees at NCH are reported to have "denied Zoher's application." (National Association Medical Staff Services [NAMSS], 2011) The board of trustees is reported to have made an adverse action report later to the NPDB, which indicated that Zoher "was denied an initial appointment and privileges." (National Association Medical Staff Services [NAMSS], 2011)

Suit Filed Against NCH and NCHS

Zoher is reported to have filed a suit against both NCH and NCHS, "seeking, in part, injunctive and declaratory relief under the HCQIA. Zoher contended that the NPDB Guidebook states that the denial of medical privileges based on a physician's failure to meet a hospital's established criteria is not a reportable event. A hospital should report a denial only if it was based on a lack of professional conduct by the physician, Zoher argued. He said NCH's denial of his privileges was based on his inability to meet the hospital's standards for appointment." (National Association Medical Staff Services [NAMSS], 2011)

II. Lacking in Subject Matter Jurisdiction

It is reported that NCH filed a motion to dismiss the lawsuit based on the fact that the court was lacking in subject matter jurisdiction and the Judge, John E. Steele was in agreement, as the only federal question at issue in the case was the claim of Zoher under the HCQIA.

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The purpose of enactment of the HCQIA was for improvement of health care and reduction of the number of physicians who were incompetent according to the statement of the court. It is reported that in actions brought by physicians that the statute "grants limited immunity from liability to individuals who participated in peer review activities that resulted in physician discipline." (National Association Medical Staff Services [NAMSS], 2011)

III. HCQIA Does Not Grant Physician Private Cause of Action in Peer Review Process

However, it is reported that the "HCQIA, however, does not grant a physician a private cause of action in connection with the peer review process, the court said. Since Zoher had no private right of action under the federal statute, there was no claim that arose under federal law in this case, and the court did not have subject matter jurisdiction, it concluded. Doctor's lawsuit against hospital that denied his application for staff appointment is dismissed because HCQIA does not provide for private right of action, federal court did not have subject matter….....

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