Thursday, April 21, 2011

Cardiologists Seek Supreme Court Review of Economic Credentialing Case

Three cardiologists have petitioned the US Supreme Court to review an appellate court decision finding that they did not have a claim against a hospital that had allegedly terminated their privileges based on their refusal to refer patients to the hospital's only cardiac surgeon. (Gaalia v. Citizens Medical Center).

The cardiologists claimed that in 2007, they refused to refer patients to Citizens Medical Center's cardiac surgeon because the surgeon's mortality rate exeeded that of other surgeons in the area. They claimed that CMC took action against them, imposing an on-call duty requirement that they were unable to fulfill, essentially leading to the termination of their privileges. They claimed that under the federal Anti-Kickback Act, the hospital wrongfully terminated their privileges under a practice of economic credentialing.

The U.S. Court of Appeals for the Fifth Circuit ruled that CMC had a rational basis for terminating the cardiologists' privileges and that the hospital committed no violation. The cardiologists are seeking review of the decision by the Supreme Court, stating that the healthcare industry needs clarification on when the federal anti-kickback statute applies.

Source: BNA

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