Delaware County Medical Society Summer/Fall 2020 - 25

Most significantly, the Superior Court emphasized that
"the PRPA only applies to the observations of and materials
produced during an evaluation by 'professional health care
providers.'" In that regard, the Court ruled that the PRPA
did not protect a "Root Cause Analysis Report," or meeting
minutes from a "Serious Safety Event Rating Committee"
and "Patient Safety Committee," because the hospital
did not provide evidence showing that the Committees
were "exclusively comprised of 'professional health care
providers.'"
The Court, in Ungurian, also ruled that a "Quality
Improvement Medical Staff Peer Review" was not entitled
to protection, because it was performed by a physician
whose medical license expired in 2014. Therefore, the
Court concluded that the reviewing physician did not
qualify as a licensed "professional health care provider,"
within the scope of the PRPA.

Key Takeaways for Medical Providers
The recent decisions in Reginelli, Estate of Krappa,
and Ungurian have caused understandable concern
among healthcare providers in Pennsylvania. However,
Pennsylvania law still provides ample room to engage
in protected peer review activities, when done through
appropriate channels.
The key takeaway is that hospitals, and other medical
practices, should have, and utilize, formal procedures and
committees for conducting true "peer review," in order to
ensure that such activities are protected under the PRPA.
It is crucial for medical providers to familiarize themselves
with the recent judicial decisions, and use those decisions
as a roadmap to update their internal procedures for
conducting peer review.
For example, facilities should update their peer review
policies to identify formal "peer review committees," with
clear procedures for conducting, and documenting, peer
review activities. The review committee's records should be
separately maintained by the committee, and only used for
peer review purposes.

Finally, it is important to recognize that certain types of
materials, such as the files of a credentialing committee,
may not be protected under current case law. For purposes
of the PRPA, activities conducted by a formal peer review
committee, through formal channels and procedures,
are most likely to be entitled to an expectation of
confidentiality.
It should also be noted that other statutes, such as the
MCARE Act and the PSQIA, may also protect other
types of reporting, compliance, and patient safety
documentation. However, it is important to carefully
review the requirements of those statutes, to ensure
compliance with the requirements for confidentiality.
Candid peer evaluations remain essential to promoting
patient safety and quality health care in Pennsylvania.
Although recent judicial decisions have potentially limited
the scope of the peer review privilege, those decisions can
be used as a roadmap to ensure that peer review activities
will be protected in the event of litigation.
1
2
3
4
5

63 P.S. ยง 425.4.
McClellan v. Health Maint. Org. of Pa., 686 A.2d 801, 805 (Pa. 1996).
Reginelli v. Boggs, 181 A.3d 293 (Pa. 2018).
Estate of Krappa v. Lyons, 211 A.3d 869 (Pa. Super. 2019).
Ungurian v. Beyzman, 2020 Pa. Super. 105 (Pa. Super. Apr. 28, 2020).

Benjamin A. Post, Esquire and Joshua T. Calo, Esquire,
Post & Post, LLC

If hospitals, or smaller practices, wish to collaborate with
outside medical providers or entities, for peer review
activities, the relationship and procedures should be clearly
documented in writing, ideally through a formal contract.
However, such practices should be carefully navigated, until
Pennsylvania courts provide further guidance on this issue.

www.delcomedsoc.org

DELAWARE COUNTY MEDICINE & HEALTH

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Delaware County Medical Society Summer/Fall 2020

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