The Shield Remains: an Overview of the Georgia Peer Review Privilege

Publication year2005
Pages0001
Georgia Bar Journal
Volume 11.

GSB Vol. 11, No. 4, Pg. 1. The Shield Remains: An Overview of the Georgia Peer Review Privilege

Georgia State Bar Journal
Vol. 11, No. 4, December 2005

"The Shield Remains: An Overview of the Georgia Peer Review Privilege"

By Josh Belinfante

In the most recent round of changes to Georgia's procedural laws governing actions for medical malpractice, the General Assembly left intact Georgia's peer review privilege. The privilege, which is often utilized in medical malpractice and wrongful termination claims, provides immunity from liability against claims based upon peer review activity and protects from discovery documents and testimony used or heard at a meeting of a peer review organization.1 The peer review privilege arose from Georgia legislators' recognition that healthcare professionals often meet to review the successes or failures of a particular procedure or of an individual's practice. The legislators believed that effective review often requires confidentiality. In the words of the Court of Appeals, the peer review statute "accords privileged status to medical review committee communications and findings because of concern that the candor necessary for these committees would be destroyed if their proceedings and conclusions were subject to use in malpractice litigation."2 This article outlines the basics of the Georgia peer review privilege: what organizations are protected; what the privilege protects against; and what is excepted from the peer review privilege.

WHAT TYPES OF ORGANIZATIONS ARE PROTECTED BY THE PEER REVIEW PRIVILEGE?

In order to qualify for the peer review privilege, an entity must be either a "review organization" or a "medical review committee." Review organizations include a broad range of medical and administrative personnel. By contrast, members of medical review committees (MRCs) must be traditional healthcare providers.

Review Organizations

Generally, review organizations must be a panel - consisting of healthcare professionals, administrators or insurers - that evaluates the quality and efficiency of medical services. Under the statute, a review organization can be either the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), another national accreditation body, or a "panel committee or organization," comprised primarily of "professional healthcare providers" or insurance carriers.3 "Professional healthcare providers" include, but are expressly not limited to healthcare practitioners, hospital and nursing home administrators, hospital and nursing home boards (including officers and directors), rehabilitation suppliers registered with the State Board of Workers' Compensation, and occupational therapists.4 A review organization "engages in or utilizes peer reviews."5 Georgia law defines peer review as: the procedure by which professional healthcare providers evaluate the quality and efficiency of services ordered or performed by other professional healthcare providers, including practice analysis, inpatient hospital and extended care facility utilization review, medical audit, ambulatory care review, claims review, underwriting assistance, and the compliance of a hospital, nursing home, convalescent home, or other healthcare facility operated by a professional healthcare provider with the standards set by an association of healthcare providers with applicable laws, rules, and regulations.6 The peer review process must be conducted for the purpose of improving the quality of healthcare, reducing morbidity and mortality, or evaluating claims made against healthcare providers.7 Ideally, an entity asserting the peer review privilege should be able to provide bylaws or other corporate documents authorizing the review organization's acts and purpose. Such documentation and procedural regularity is not, however, always mandatory: the Georgia Court of Appeals has said there is "no condition precedent attached requiring [review organizations] to operate according to written bylaws."8 It would appear to follow, therefore, that alleged violations of a review organization's bylaws would not waive the privilege either.

Medical Review Committees

Medical review committees are similar to review organizations, but the code narrowly defines their composition and scope.9 An MRC is "a committee of a state or local professional society or of a medical staff or a licensed hospital, nursing home, medical foundation, or peer review committee."10 The Georgia Court of Appeals...

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