Interesting Case - Federal Health Care Quality Improvement Act Doesn't Allow Doctor to Sue for NPDB Report

Zoher, a medical doctor licensed to practice in Florida, applied for a staff position at Naples Community Hospital (NCH), a facility operated by defendant NCH Healthcare System Inc. (NCHS). NCH's board of trustees denied Zoher's application. It later made an adverse action report to the NPDB indicating that Zoher was denied an initial appointment and privileges.

Zoher brought suit against 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.

NCH moved to dismiss the lawsuit on the basis that the court lacked subject matter jurisdiction. In a decision by Judge John E. Steele, the court agreed.

The court found that it did not have jurisdiction because the only federal question at issue was Zoher's claim under the HCQIA.
The HCQIA was enacted to improve health care and reduce the number of incompetent physicians, the court said. In actions brought by physicians, the statute grants limited immunity from liability to individuals who participated in peer review activities that resulted in physician discipline, it said.

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 jurisdiction over doctor's action.

A physician cannot recover damages from a hospital for allegedly mistakenly reporting a clinical action against him to the National Practitioner Data Bank (NPDB), a federal district court said Nov. 14 in dismissing the action (Zoher v. NCH Healthcare System Inc., M.D. Fla., No. 2:11-cv-86, 11/14/11).

The U.S. District Court for the Middle District of Florida noted that there is no private right of action under the Health Care Quality Improvement Act (HCQIA) and, therefore, Dr. Mina Zoher failed to state a claim within the court's federal question subject matter jurisdiction.

For full text of the court's opinion: http://op.bna.com/hl.nsf/r?Open=mapi-8nmlb9.