PL 99-660: improved protections or expensive requirements?

The Healthcare Quality Improvement Act of 1986 (Public Law 99-660) offers immunity from monetary damages for peer review actions and protection for patients from incompetent physicians. Institutions may find, however, that its notice and hearing requirements are costly and offer no more than existing protections. "Deemed compliance" procedures may also differ greatly from facilities' current practices. The act, effective November 1986, applies to actions under federal law and may extend to state law in October 1989. Its advantages may include earlier dismissals of suits and a further disincentive for antitrust actions, as the Ninth Circuit's Patrick v. Burget decision already suggests. Facilities should examine costs and benefits of compliance and alternatives to the hearing process, as well as the effect on the national clearinghouse that the act will establish for reporting problem physicians.