Page:United States Statutes at Large Volume 100 Part 5.djvu/319

 PUBLIC LAW 99-660—NOV. 14, 1986

100 STAT. 3793

(7) The term "medical malpractice action or claim" means a i written claim or demand for payment based on a health care provider's furnishing (or failure to furnish) health care services, tand includes the filing of a cause of action, based on the law of e tort, brought in any court of any State or the United States 3 seeking monetary damages. (8) The term "physician" means a doctor of medicine or osteopathy or a doctor of dental surgery or medical dentistry legally authorized to practice medicine and surgery or dentistry 0 by a State (or any individual who, without authority holds ^i^ himself or herself out to be so authorized). (9) The term "professional review action" means an action or ? ^ recommendation of a professional review body which is taken or made in the conduct of professional review activity, which is t, based on the competence or professional conduct of an individ0 ual physician (which conduct affects or could affect adversely 9 the health or welfare of a patient or patients), and which affects ty (or may affect) adversely the clinical privileges, or membership s in a professional society, of the physician. Such term includes a b formal decision of a professional review body not to take an ft action or make a recommendation described in the previous sentence and also includes professional review activities relatj ing to a professional review action. In this title, an action is not p. considered to be based on the competence or professional con^ duct of a physician if the action is primarily based on— i^ (A) the physician's association, or lack of association, with f a professional society or association, f (B) the physician's fees or the physician's advertising or engaging in other competitive acts intended to solicit or retain business, (C) the physician's participation in prepaid group health plans, salaried employment, or any other manner of delivering health services whether on a fee-for-service or other basis, (D) a physician's association with, supervision of, delega,^, tion of authority to, support for, training of, or participation in a private group practice with, a member or members of a particular class of health care practitioner or professional, or (E) any other matter that does not relate to the competence or professional conduct of a physician. iBim ^^^^ '^^ term "professional review activity" means an activity of a health care entity with respect to an individual physician— (A) to determine whether the physician may have clinical •~hm privileges with respect to, or membership in, the entity, Qfi* (B) to determine the scope or conditions of such privileges or membership, or (C) to change or modify such privileges or membership. (11) The term "professional review body" means a health care entity and the governing body or any committee of a health care entity which conducts professional review activity, and includes any committee of the medical staff of such an entity when assisting the governing body in a professional review activity. (12) The term "Secretary" means the Secretary of Health and Human Services.

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