CHAPTER 15. HEALTH CARE: PRIVILEGED COMMUNICATIONS OF HEALTH CARE PROVIDER PEER REVIEW COMMITTEES
IC 34-30-15
Chapter 15. Health Care: Privileged Communications of Health
Care Provider Peer Review Committees
IC 34-30-15-1
Confidentiality; peer review committee proceedings
Sec. 1. (a) All proceedings of a peer review committee are
confidential.
(b) All communications to a peer review committee shall be
privileged communications.
(c) Neither the personnel of a peer review committee nor any
participant in a committee proceeding shall reveal any content of:
(1) communications to;
(2) the records of; or
(3) the determination of;
a peer review committee outside of the peer review committee.
(d) However, the governing board of:
(1) a hospital;
(2) a professional health care organization;
(3) a preferred provider organization (including a preferred
provider arrangement or reimbursement agreement under
IC 27-8-11); or
(4) a health maintenance organization (as defined in
IC 27-13-1-19) or a limited service health maintenance
organization (as defined in IC 27-13-34-4);
may disclose the final action taken with regard to a professional
health care provider without violating the provisions of this section.
(e) Upon approval by the health care facility's governing body, the
peer review committee of a health care facility (as defined in
IC 16-40-5-2) may submit or disclose to the agency (as defined in
IC 16-40-5-1) the following for purposes of patient safety or quality
of health care matters under IC 16-40-5:
(1) Communications to the peer review committee.
(2) Peer review committee proceedings.
(3) Peer review committee records.
(4) Determinations by the peer review committee.
Information and materials submitted or disclosed to the agency under
this subsection are confidential and privileged from use as evidence
in an administrative or judicial proceeding, and notwithstanding
IC 16-40-5, the agency may not release the information or material
outside the agency. However, the agency may issue a report that is
based upon information or materials submitted or disclosed to the
agency by a peer review committee if the report or any other
information issued does not disclose the identity of the health care
facility, health care provider, or patient. Information and materials
may be submitted or disclosed to the agency under this subsection
without violating this section or waiving the confidentiality and
privilege attached to the communications, proceedings, records,
determinations, or deliberations of the peer review committee.
(f) Upon its determination, the governing body of a hospital may
report, as part of the hospital's quality assessment and improvement
program, a determination of a peer review committee of the hospital
regarding an adverse event concerning patient care to the state
department of health or another state agency without:
(1) violating this section; or
(2) waiving the confidentiality and privilege attached to the
communications, proceedings, records, determinations, or
deliberations of the peer review committee.
As added by P.L.1-1998, SEC.26. Amended by P.L.101-2007, SEC.4.
IC 34-30-15-2
Confidentiality; peer review committee proceedings; persons
attending
Sec. 2. Except as otherwise provided in this chapter, a person who
attends a peer review committee proceeding shall not be permitted or
required to disclose:
(1) any information acquired in connection with or in the course
of a proceeding;
(2) any opinion, recommendation, or evaluation of the
committee; or
(3) any opinion, recommendation, or evaluation of any
committee member.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-3
Confidentiality; otherwise discoverable information
Sec. 3. (a) Information that is otherwise discoverable or
admissible from original sources is not immune from discovery or
use in any proceeding merely because it was presented during
proceedings before a peer review committee.
(b) A member, an employee, an agent of a committee or other
person appearing before the committee may not be prevented from
testifying:
(1) as to matters within the person's knowledge; and
(2) in accordance with the other provisions of this chapter.
(c) However, the witness cannot be questioned about this
testimony or other proceedings before the committee or about
opinions formed by the witness as a result of committee hearings.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-4
Health care providers under investigation; access to records
Sec. 4. (a) A professional health care provider under investigation
shall be permitted at any time to see any records accumulated by a
peer review committee pertaining to the provider's personal practice.
(b) The provider shall be offered the opportunity to appear before
the peer review committee with adequate representation to hear all
charges and findings concerning the provider's practice and to offer
rebuttal information.
(c) The rebuttal information shall be a part of the record before
any disclosure of the charges and findings under this chapter is made.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-5
Health care providers under investigation; hearings
Sec. 5. (a) As used in this section, "conflicted medical staff
member" means a professional health care provider who is a member
of a hospital's medical staff and who is determined by the hospital to
be:
(1) in direct economic competition with the professional health
care provider against whom the charges have been brought; or
(2) reasonably unavailable to serve on a peer review committee
of the medical staff.
(b) Except as provided in section 6(b) of this chapter, if charges
are brought against a professional health care provider in a hospital
that, if sustained by the governing board of the hospital, could result
in an action against a physician required to be reported to the medical
licensing board under IC 16-21-2-6 or a similar disciplinary action
against any other health care provider, the professional health care
provider is entitled to:
(1) one (1) evidentiary hearing before a peer review committee
of the medical staff; and
(2) one (1) appeal before the governing board of the hospital or
a committee appointed by the governing board.
(c) If a hospital determines that a peer review committee of the
medical staff may not be formed without appointing a conflicted
medical staff member, the hospital:
(1) may not appoint the conflicted medical staff member to the
peer review committee; and
(2) shall appoint a professional health care provider who:
(A) holds the same professional license as the provider
against whom the charges have been brought; and
(B) is not a member of the hospital's medical staff;
to serve on the peer review committee.
(d) The professional health care provider appointed under
subsection (c)(2) may not be in direct economic competition with the
professional health care provider against whom the charges have
been brought.
As added by P.L.1-1998, SEC.26. Amended by P.L.127-1999, SEC.1.
IC 34-30-15-6
Health care providers under investigation; appeals
Sec. 6. (a) Any appeal granted to a professional health care
provider under section 5 of this chapter may be held before a
committee of the board of trustees or the full board of trustees of the
hospital in which the care under investigation was provided.
(b) The right to a hearing and appeal under this chapter in regard
to cases involving care provided for hospitals, health care facilities,
and health care organizations is confined to professional health care
providers who are granted or who have applied for privileges as
independent practitioners. That right is not applicable to any
professional health care provider who works in the hospital or health
care facility solely as an employee or as the employee of another
independent professional health care provider.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-7
Health care providers under investigation; health maintenance
organizations
Sec. 7. (a) This section applies to:
(1) a health maintenance organization (as defined in
IC 27-13-1-19); or
(2) a limited service health maintenance organization (as
defined in IC 27-13-34-4).
(b) Before:
(1) taking corrective action against a professional health care
provider who is under contract with but not employed by the
health maintenance organization or limited service health
maintenance organization; or
(2) taking action to terminate a contract with a professional
health care provider who is not employed by the health
maintenance organization or limited service health maintenance
organization;
based upon an evaluation of patient care rendered by the professional
health care provider, the organization shall grant the health care
provider affected by the action one (1) evidentiary hearing before a
peer review committee of the organization and, at the health
provider's request, an appeal of the peer review committee's decision.
(c) Unless otherwise agreed to by the organization and the health
care provider, the appeal must be limited to a review of the record of
the hearing before the peer review committee and a review of all or
part of the peer review committee's decision.
(d) The appeal must be held before the governing board of the
organization or, at the governing board's discretion, before a
committee of the governing board.
(e) The health care provider is entitled to submit written materials
in support of the appeal and, at the discretion of the governing board
or committee of the board conducting the appeal, the health care
provider may be allowed to present oral argument in support of the
appeal.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-8
Confidentiality; persons information may be disclosed to
Sec. 8. (a) Communications to, the records of, and determinations
of a peer review committee may only be disclosed to:
(1) the peer review committee of:
(A) a hospital;
(B) a nonprofit health care organization (described in
IC 34-6-2-117(23));
(C) a preferred provider organization (including a preferred
provider arrangement or reimbursement agreement under
IC 27-8-11);
(D) a health maintenance organization (as defined in
IC 27-13-1-19) or a limited service health maintenance
organization (as defined in IC 27-13-34-4); or
(E) another health facility;
(2) the disciplinary authority of the professional organization of
which the professional health care provider under question is a
member; or
(3) the appropriate state board of registration and licensure that
the committee considers necessary for recommended
disciplinary action;
and shall otherwise be kept confidential for use only within the scope
of the committee's work, unless the professional health care provider
has filed a prior written waiver of confidentiality with the peer
review committee.
(b) However, if a conflict exists between this section and
IC 27-13-31, the provisions of IC 27-13-31 control.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-9
Waiver of privilege
Sec. 9. Except in cases of required disclosure to the professional
health care provider under investigation, no records or
determinations of or communications to a peer review committee
shall be:
(1) subject to subpoena or discovery; or
(2) admissible in evidence;
in any judicial or administrative proceeding, including a proceeding
under IC 34-18-11 (or IC 27-12-11 before its repeal), without a prior
waiver executed by the committee.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-10
Invoking privilege
Sec. 10. Except in cases as authorized in this chapter, the
evidentiary privileges created by this chapter shall be invoked by all
witnesses and organizations in all judicial and administrative
proceedings unless the witness or organization first has a waiver of
the privilege executed in writing, on behalf of the peer review
committee holding the privilege, by its chairman, vice chairman, or
secretary.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-11
Limited waiver of privilege for attorney general investigation
Sec. 11. If a waiver of the privilege is executed on behalf of the
peer review committee in favor of the attorney general for the
purpose of conducting an investigation under IC 25-1-7, the records
of, determinations of, or communications to a peer review committee
are confidential and privileged under this section, except for the
attorney general's use in an investigation to identify information
otherwise discoverable or admissible from original sources under
section 3 of this chapter.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-12
Subpoena powers of attorney general
Sec. 12. This chapter does not prevent the attorney general from
obtaining by subpoena as part of an investigation under IC 25-1-7 for
a violation under IC 25-1-9:
(1) the application for privileges or employment completed by
the professional staff member under investigation regardless of
whether the member is the subject of peer review committee
proceedings;
(2) except for reports prepared as part of a peer review
investigation, incident reports prepared contemporaneously to
document the circumstances of an accident or unusual
occurrence involving a professional staff member regardless of
whether the member is the subject of peer review committee
proceedings; or
(3) information otherwise discoverable from original sources,
that is not the communications to, records of, or determinations
of a peer review committee;
from a professional health care provider.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-13
Subpoena powers of attorney general; requirements
Sec. 13. A subpoena issued by the attorney general to obtain the
records necessary to an investigation shall identify with reasonable
particularity the documents sought and the specific professional
health care provider under investigation.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-14
Immunities inapplicable to persons violating confidentiality
requirements
Sec. 14. The immunities granted by sections 15 through 20 of this
chapter shall not extend to any person who violates the
confidentiality requirements of sections 1 through 13 of this chapter.
As added by P.L.1-1998, SEC.26. Amended by P.L.1-1999, SEC.74;
P.L.97-2004, SEC.123.
IC 34-30-15-15
Immunity; peer review committee proceedings
Sec. 15. There is no liability on the part of, and no action of any
nature shall arise against, the personnel of a peer review committee
for any act, statement made in the confines of the committee, or
proceeding of the committee made in good faith in regard to
evaluation of patient care as that term is defined and limited in
IC 34-6-2-44.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-16
Immunity; disclosure of information to peer review committee
Sec. 16. Notwithstanding any other law, a peer review committee,
an organization, or any other person who, in good faith and as a
witness or in some other capacity, furnishes records, information, or
assistance to a peer review committee that is engaged in:
(1) the evaluation of the qualifications, competence, or
professional conduct of a professional health care provider; or
(2) the evaluation of patient care;
is immune from any civil action arising from the furnishing of the
records, information, or assistance, unless the person knowingly
furnishes false records or information.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-17
Immunity; good faith determinations regarding evaluation of
patient care
Sec. 17. The personnel of a peer review committee shall be
immune from any civil action arising from any determination made
in good faith in regard to evaluation of patient care as that term is
defined and limited in IC 34-6-2-44.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-18
Injunctive relief unavailable
Sec. 18. No restraining order or injunction shall be issued against
a peer review committee or any of the personnel thereof to interfere
with the proper functions of the committee acting in good faith in
regard to evaluation of patient care as that term is defined and limited
in IC 34-6-2-44.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-19
Immunity; compliance with federal Health Care Quality
Improvement Act
Sec. 19. If the action of the peer review committee meets the
standards specified by this chapter and the federal Health Care
Quality Improvement Act of 1986, 42 U.S.C. 11101 et seq., the
following persons are not liable for damages under any federal, state,
or local law with respect to the action:
(1) The peer review committee.
(2) Any person acting as a member or staff to the peer review
committee.
(3) Any person under a contract or other formal agreement with
the peer review committee.
(4) Any person who participates with or assists the peer review
committee with respect to the action.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-20
Immunity; inapplicable to civil rights laws
Sec. 20. Section 19 of this chapter does not apply to damages
under any federal or state law relating to the civil rights of a person
including:
(1) the federal Civil Rights Act of 1964, 42 U.S.C. 2000e, et
seq.; and
(2) the federal Civil Rights Act, 42 U.S.C. 1981, et seq.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-21
Use of information for internal business purposes
Sec. 21. (a) Notwithstanding sections 1 through 14 of this chapter:
(1) a professional health care provider;
(2) a peer review committee; and
(3) the governing board of:
(A) a hospital;
(B) a preferred provider organization (including a preferred
provider arrangement or reimbursement agreement under
IC 27-8-11);
(C) a health maintenance organization (as defined in
IC 27-13-1-19) or a limited service health maintenance
organization (as defined in IC 27-13-34-4); or
(D) a professional health care organization;
may use information obtained by peer review committees for
legitimate internal business purposes.
(b) Legitimate internal business uses of information obtained by
a peer review committee include the following:
(1) Quality review and assessment.
(2) Utilization review and management.
(3) Risk management and incident reporting.
(4) Safety, prevention, and correction.
(5) Reduction of morbidity and mortality.
(6) Scientific, statistical, and educational purposes.
(7) Legal defense.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-22
Discovery of financial incentives offered provider
Sec. 22. Evidence of any financial incentive offered to or withheld
from:
(1) a private psychiatric hospital licensed under IC 12-25; or
(2) a preferred provider organization (including a preferred
provider arrangement or reimbursement agreement under
IC 27-8-11);
is subject to discovery under Indiana Rules of Trial Procedure unless
specifically protected by statute.
As added by P.L.1-1998, SEC.26.
IC 34-30-15-23
Good faith presumed; malice must be proven
Sec. 23. In all actions to which this chapter applies, good faith
shall be presumed, and malice shall be required to be proven by the
person aggrieved.
As added by P.L.1-1998, SEC.26.