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42 U.S.C. § 11131 — Construction

Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 11131 — Construction

**(a) In general** Except as specifically provided in this subchapter, nothing in this subchapter shall be construed as changing the liabilities or immunities under law or as preempting or overriding any State law which provides incentives, immunities, or protection for those engaged in a professional review action that is in addition to or greater than that provided by this subchapter. **(b) Scope of clinical privileges** Nothing in this subchapter shall be construed as requiring health care entities to provide clinical privileges to any or all classes or types of physicians or other licensed health care practitioners. **(c) Treatment of nurses and other practitioners** Nothing in this subchapter shall be construed as affecting, or modifying any provision of Federal or State law, with respect to activities of professional review bodies regarding nurses, other licensed health care practitioners, or other health professionals who are not physicians. **(d) Treatment of patient malpractice claims** Nothing in this chapter shall be construed as affecting in any manner the rights and remedies afforded patients under any provision of Federal or State law to seek redress for any harm or injury suffered as a result of negligent treatment or care by any physician, health care practitioner, or health care entity, or as limiting any defenses or immunities available to any physician, health care practitioner, or health care entity.

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Source file: Laws/federal/codes/united-states-code/title-42/section-11131-construction--387fc9f588.md
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Source location: Title 42, Chapter 117, § 11131; chapter-117-encouraging-good-faith-professional-review-activities.md

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 11137 — Disclosure and correction of information

With respect to the information reported to the Secretary (or the agency designated under [section 11134(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section11134/b&num=0&edition=prelim)) under this subchapter respecting a physician or other licensed health care practitioner, the Secretary shall, by regulation, provide for— (1) disclosure of the information, upon request, to the physician or practitioner, and (2) procedures in the case of disputed accuracy of the information.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 11135 — Form of reporting

**(a) Timing and form** The information required to be reported under sections 11131, 11132(a), and 11133 of this title shall be reported regularly (but not less often than monthly) and in such form and manner as the Secretary prescribes. Such information shall first be required to be reported on a date (not later than one year after November 14, 1986) specified by the Secretary. **(b) To whom reported** The information required to be reported under sections 11131, 11132(a), and 11133(b) of this title shall be reported to the Secretary, or, in the Secretary’s discretion, to an appropriate private or public agency which has made suitable arrangements with the Secretary with respect to receipt, storage, protection of confidentiality, and dissemination of the information under this subchapter. **(c) Reporting to State licensing boards** (1) **Malpractice payments** — Information required to be reported under [section 11131 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section11131&num=0&edition=prelim) shall also be reported to the appropriate State licensing board (or boards) in the State in which the medical malpractice claim arose. (2) **Reporting to other licensing boards** — Information required to be reported under [section 11133(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section11133/b&num=0&edition=prelim) shall also be reported to the appropriate State licensing board in the State in which the health care entity is located if it is not otherwise reported to such board under subsection (b).

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1320a–7e — Health care fraud and abuse data collection program

**(a) In general** The Secretary shall maintain a national health care fraud and abuse data collection program under this section for the reporting of certain final adverse actions (not including settlements in which no findings of liability have been made) against health care providers, suppliers, or practitioners as required by subsection (b), with access as set forth in subsection (d), and shall furnish the information collected under this section to the National Practitioner Data Bank established pursuant to the Health Care Quality Improvement Act of 1986 ([42 U.S.C. 11101](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section11101&num=0&edition=prelim) et seq.). **(b) Reporting of information** (1) **In general** — Each Government agency and health plan shall report any final adverse action (not including settlements in which no findings of liability have been made) taken against a health care provider, supplier, or practitioner. (2) **Information to be reported** — The information to be reported under paragraph (1) includes: (A) The name and TIN (as defined in section 7701(a)(41) of the Internal Revenue Code of 1986) of any health care provider, supplier, or practitioner who is the subject of a final adverse action. (B) The name (if known) of any health care entity with which a health care provider, supplier, or practitioner, who is the subject of a final adverse action, is affiliated or associated. (C) The nature of the final adverse action and whether such action is on appeal. (D) A description of the acts or omissions and injuries upon which the final adverse action was based, and such other information as the Secretary determines by regulation is required for appropriate interpretation of information reported under this se

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1396r–2 — Information concerning sanctions taken by State licensing authorities against health care practitioners and providers

**(a) Information reporting requirement** The requirement referred to in [section 1396a(a)(49) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/49&num=0&edition=prelim) is that the State must provide for the following: (1) **Information reporting system** (A) *Licensing or certification actions* — The State must have in effect a system of reporting the following information with respect to formal proceedings (as defined by the Secretary in regulations) concluded against a health care practitioner or entity by a State licensing or certification agency: (i) Any adverse action taken by such licensing authority as a result of the proceeding, including any revocation or suspension of a license (and the length of any such suspension), reprimand, censure, or probation. (ii) Any dismissal or closure of the proceedings by reason of the practitioner or entity surrendering the license or leaving the State or jurisdiction. (iii) Any other loss of license or the right to apply for, or renew, a license by the practitioner or entity, whether by operation of law, voluntary surrender, nonrenewability, or otherwise. (iv) Any negative action or finding by such authority, organization, or entity regarding the practitioner or entity. (B) *Other final adverse actions* — The State must have in effect a system of reporting information with respect to any final adverse action (not including settlements in which no findings of liability have been made) taken against a health care provider, supplier, or practitioner by a State law or fraud enforcement agency. (2) **Access to documents** — The State must provide the Secretary (or an entity designated by the Secretary) with access to such documents of a State licensing or

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 11131 — Requiring reports on medical mal-

Page 8116 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 11113 (D) upon completion of the hearing, the physician involved has the right— (i) to receive the written recommenda- tion of the arbitrator, officer, or panel, in- cluding a statement of the basis for the recommendations, and (ii) to receive a written decision of the health care entity, including a statement of the basis for the decision. A professional review body’s failure to meet the conditions described in this subsection shall not, in itself, constitute failure to meet the stand- ards of subsection (a)(3). (c) Adequate procedures in investigations or health emergencies For purposes of section 11111(a) of this title, nothing in this section shall be construed as— (1) requiring the procedures referred to in subsection (a)(3)— (A) where there is no adverse professional review action taken, or (B) in the case of a suspension or restric- tion of clinical privileges, for a period of not longer than 14 days, during which an inves- tigation is being conducted to determine the need for a professional review action; or (2) precluding an immediate suspension or restriction of clinical privileges, subject to subsequent notice and hearing or other ade- quate procedures, where the failure to take such an action may result in an imminent danger to the health of any individual. (Pub. L. 99–660, title IV, § 412, Nov. 14, 1986, 100 Stat. 3785.) § 11113. Payment of reasonable attorneys’ fees and costs in defense of suit In any suit brought against a defendant, to the extent that a defendant has met the standards set forth under section 11112(a) of this title and the defendant substantially prevails, the court shall, at the conclusion of the action, award to a substantially prevailing party defendin

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