Review of Quality Care, Health Care Provider Peer Review

Committees, Immunity from Liability; Privileged Communications; Discovery; Testimony; Delegation of Authority.

(a)Every health care provider may establish procedures for continuously reviewing and improving the quality of care, performance of medical personnel, utilization of services and facilities, and costs. Notwithstanding any other provision of law, there shall be no monetary liability on the part of, and no cause of action for damages shall arise against any person, partnership, corporation, firm, society or other entity arising from, relating to, or regarding:

(1)participation in quality of care or utilization reviews by plan or health care provider peer review committees which are licensed health care providers composed mainly of physicians and surgeons, dentists, nurses, allied health professionals, optometrists or any of the above;

(2)communication of information, the making or issuance of any recommendation or evaluation to any governmental agency, medical or specialists society, regarding the qualifications, fitness, professional conduct or practices of health care professionals, which communication, recommendation, and evaluation are the results of peer reviews or quality of care or utilization reviews;

(3)any act performed during peer reviews or quality of care utilization reviews if the person acts in good faith without malice. Neither the proceedings nor the records of the reviews shall be subject to discovery except as provided in Subsection (f). Nor shall any person in attendance at, serving on, or communicating information to any review committee described in this Section disclose or be examined as to any communication thereto, what transpired therein or the findings thereof, except to the extent necessary to carry out one or more of the purposes of the review organization. Disclosure of the proceedings or records to the governing body of a health care provider, to the person who is the subject of committee review or to any person or entity designated by the health care provider to review activities of the COL1242015 2006 GUAM RULES OF EVIDENCE ART. IV: RELEVANCY AND ITS LIMITS committees shall not alter the status of the records or of the proceedings as privileged communications.

(b)The prohibitions in this Section do not prevent any person who is party to any action or proceeding from being examined in such action or proceeding regarding his or her statements to the committee when his or her conduct is being reviewed.

(c)This section shall not be construed to confer immunity from liability on any health care provider. In any case in which, for but the enactment of the preceding provisions of this Section, a cause of action would arise against a health care provider, the cause of action shall exist notwithstanding the provisions of this Section.

(d)Medical records and non-privileged information discovered by independent means are not included in this Section's prohibition relating to discovery. For the purposes of this Section, “proceedings and records of review committees” include, but are not limited to: recordings, transcripts, minutes, summaries and reports of committee meetings, and the conclusions contained therein.

(e)Nothing in this section shall be construed to prevent a health care provider from utilizing subcommittees to participate in peer review activities, nor to prevent a plan or health care provider from delegating the responsibilities required by this section, as it determines to be appropriate, to subcommittees including subcommittees composed of a majority of non-physician health care providers licensed pursuant to Guam law, so long as the plan or health care provider controls the scope of authority delegated and may revoke all or part of this authority at any time. Persons who participate in the subcommittees shall be entitled to the same immunity from monetary liability and actions for civil damages as persons who participate in provider peer review committees pursuant to this section.

(f)The prohibitions in this Section shall not affect the discovery or the use of relevant evidence in any criminal action; provided, however, that the materials afforded protection under this Section may only be discovered in criminal matters upon an adequate showing that exceptional circumstances exist requiring their discovery and the administration of justice would otherwise be impeded without production thereof. Protection from discovery shall not apply to judicial proceedings in which a health care practitioner contests the denial, restriction or termination of clinical privileges by a COL1242015 2006 GUAM RULES OF EVIDENCE ART. IV: RELEVANCY AND ITS LIMITS hospital or clinic.

(g)“Health care providers” as the term is used in this Section, means a licensed organization engaged in the providing of personal health service to the public. Such licensed organizations include hospitals, clinics, health maintenance organizations and nursing homes, but do not include individual or sole practitioners.

(h)In all cases, the peer review committee or subcommittee shall make its findings available within the reporting guidelines of the National Practitioner Data Bank under the Health Care Quality Improvement Act of 1986 and within twenty-one

(21)days to:

(i)the medical or dental professional being assessed,

(ii)each licensure entity or board which has licensed the person reviewed,

(iii)the employer, if any, of the person reviewed, and

(iv)Guam Memorial Hospital Authority, if such committee or subcommittee finds any one

(1)of the following:

(i)the person reviewed has an alcohol or substance abuse problem;

(ii)there are serious quality of care issues regarding the person’s practice;

(iii)to permit the person reviewed to continue practicing that person’s profession would represent a significant threat to the health or lives of patients;

(iv)the person reviewed has refused to or failed to take remedial actions recommended by the committee or subcommittee;

(v)the person reviewed has violated any law relating to controlled substances;

(vi)the person reviewed was or is licensed or has continued to be licensed based upon fraudulent documents or statements;

(vii)the person reviewed is physically or mentally incapable of performing some or all of the duties normally performed by a practitioner of his or her specialty or profession; COL1242015 2006 GUAM RULES OF EVIDENCE ART. IV: RELEVANCY AND ITS LIMITS

(viii)the person reviewed has consistently failed to follow generally accepted medical or dental procedures;

(ix)the person reviewed has violated the ethical standards of his or her profession; or

(x)convicted of a felony. If either subitems

(v)or

(x)is found to apply, the committee or subcommittee making the review shall notify the Guam Police Department, the National Practitioners Databank, the Attorney General, and the U. S. Attorney (if a federal crime is involved). In addition, such committee or subcommittee may make its findings available to any of the above named organizations or persons if such committee or subcommittee finds it are necessary to protect the patients of the person reviewed.