Peer review protection: Pish-Posh or pivotal policy?

The Healthcare Quality Improvement Act (HCQIA) of 1986 is a pivotal federal mandate designed to enhance medical care quality through effective professional peer review. Importantly, it offers legal immunity to reviewers under specified conditions and mandates the reporting of adverse actions to the National Practitioner Data Bank (NPDB). This article explores the implementation of peer review processes in hospitals and the potentially severe ramifications of failure to report, using the scenario of a diagnostic radiologist performing high-end vascular interventional procedures, whose performance came under scrutiny, highlighting the intersection of federal and state laws, accreditation standards, hospital policies, and physician professionalism standards and reporting duties.