537.035. Peer review committees--composition, purpose--immunity from civil liability, who, when--disclosure of records prohibited, exceptions--testimony before, discovery and admissibility, limitation - Missouri Statutes

Peer review committees--composition, purpose--immunity from civilliability, who, when--disclosure of records prohibited,exceptions--testimony before, discovery and admissibility,limitations.

537.035. 1. As used in this section, unless the context clearlyindicates otherwise, the following words and terms shall have the meaningsindicated:

(1) "Health care professional", a physician or surgeon licensed underthe provisions of chapter 334, RSMo, or a dentist licensed under theprovisions of chapter 332, RSMo, or a podiatrist licensed under theprovisions of chapter 330, RSMo, or an optometrist licensed under theprovisions of chapter 336, RSMo, or a pharmacist licensed under theprovisions of chapter 338, RSMo, or a chiropractor licensed under theprovisions of chapter 331, RSMo, or a psychologist licensed under theprovisions of chapter 337, RSMo, or a nurse licensed under the provisionsof chapter 335, RSMo, or a social worker licensed under the provisions ofchapter 337, RSMo, or a professional counselor licensed under theprovisions of chapter 337, RSMo, or a mental health professional as definedin section 632.005, RSMo, while acting within their scope of practice;

(2) "Peer review committee", a committee of health care professionalswith the responsibility to evaluate, maintain, or monitor the quality andutilization of health care services or to exercise any combination of suchresponsibilities.

2. A peer review committee may be constituted as follows:

(1) Comprised of, and appointed by, a state, county or local societyof health care professionals;

(2) Comprised of, and appointed by, the partners, shareholders, oremployed health care professionals of a partnership or professionalcorporation of health care professionals, or employed health careprofessionals of a university or an entity affiliated with a universityoperating under chapter 172, 174, 352, or 355, RSMo;

(3) Appointed by the board of trustees, chief executive officer, orthe organized medical staff of a licensed hospital, or other healthfacility operating under constitutional or statutory authority, includinglong-term care facilities licensed under chapter 198, RSMo, or anadministrative entity of the department of mental health recognizedpursuant to the provisions of subdivision (3) of subsection 1 of section630.407, RSMo;

(4) Any other organization formed pursuant to state or federal lawauthorized to exercise the responsibilities of a peer review committee andacting within the scope of such authorization;

(5) Appointed by the board of directors, chief executive officer orthe medical director of the licensed health maintenance organization.

3. Each member of a peer review committee and each person, hospitalgoverning board, health maintenance organization board of directors, andchief executive officer of a licensed hospital or other hospital operatingunder constitutional or statutory authority, chief executive officer ormedical director of a licensed health maintenance organization whotestifies before, or provides information to, acts upon the recommendationof, or otherwise participates in the operation of, such a committee shallbe immune from civil liability for such acts so long as the acts areperformed in good faith, without malice and are reasonably related to thescope of inquiry of the peer review committee.

4. Except as otherwise provided in this section, the interviews,memoranda, proceedings, findings, deliberations, reports, and minutes ofpeer review committees, or the existence of the same, concerning the healthcare provided any patient are privileged and shall not be subject todiscovery, subpoena, or other means of legal compulsion for their releaseto any person or entity or be admissible into evidence in any judicial oradministrative action for failure to provide appropriate care. Except asotherwise provided in this section, no person who was in attendance at anypeer review committee proceeding shall be permitted or required to discloseany information acquired in connection with or in the course of suchproceeding, or to disclose any opinion, recommendation, or evaluation ofthe committee or board, or any member thereof; provided, however, thatinformation otherwise discoverable or admissible from original sources isnot to be construed as immune from discovery or use in any proceedingmerely because it was presented during proceedings before a peer reviewcommittee nor is a member, employee, or agent of such committee, or otherperson appearing before it, to be prevented from testifying as to matterswithin his personal knowledge and in accordance with the other provisionsof this section, but such witness cannot be questioned about testimony orother proceedings before any health care review committee or board or aboutopinions formed as a result of such committee hearings. The disclosure ofany interview, memoranda, proceedings, findings, deliberations, reports, orminutes to any person or entity, including but not limited to governmentalagencies, professional accrediting agencies, or other health careproviders, whether proper or improper, shall not waive or have any effectupon its confidentiality, nondiscoverability, or nonadmissibility.

5. The provisions of subsection 4 of this section limiting discoveryand admissibility of testimony as well as the proceedings, findings,records, and minutes of peer review committees do not apply in any judicialor administrative action brought by a peer review committee or the legalentity which formed or within which such committee operates to deny,restrict, or revoke the hospital staff privileges or license to practice ofa physician or other health care providers; or when a member, employee, oragent of the peer review committee or the legal entity which formed suchcommittee or within which such committee operates is sued for actions takenby such committee which operate to deny, restrict or revoke the hospitalstaff privileges or license to practice of a physician or other health careprovider.

6. Nothing in this section shall limit authority otherwise providedby law of a health care licensing board of the state of Missouri to obtaininformation by subpoena or other authorized process from peer reviewcommittees or to require disclosure of otherwise confidential informationrelating to matters and investigations within the jurisdiction of suchhealth care licensing boards.

(L. 1973 S.B. 62 § 1, A.L. 1977 H.B. 562, A.L. 1985 H.B. 357, A.L. 1993 S.B. 388, A.L. 1997 H.B. 335, A.L. 2005 H.B. 393)

CROSS REFERENCE:

Applicability of statute changes to cases filed after August 28, 2005, RSMo 538.305

(1984) No peer review privilege of confidentiality exists for statements or documents since such privilege is separate and distinct from the statutory immunity from civil liability granted to medical personnel participating in peer review. State ex rel. Chandra v. Sprinkle (Mo. banc), 678 S.W.2d 804.

(1986) The proceedings, findings, deliberations, reports and minutes of peer review committees are not discoverable. State ex rel. Faith Hospital v. Enright (Mo. banc), 706 S.W.2d 852.

(2006) Subsection (4) of section prohibiting disclosure by healthcare facility of medical peer review committee reports is preempted by Protection and Advocacy for Mentally Ill Individuals Act. Missouri Protection & Advocacy Services v. Missouri Department of Mental Health, 447 F.3d 1021 (8th Cir.).