Heyl Royster

Illinois Supreme Court Rules Credentialing Applications are Discoverable in Case Against Hospital

january 26, 2016

By: Richard Hunsakerrhunsaker@heylroyster.com

On January 22, the Illinois Supreme Court issued an opinion in the case of Klaine v. Southern Illinois Hospital Services, 2016 IL 118217, holding that applications submitted in the hospital's confidential credentialing process are discoverable. The court rested its decision on the fact that the hospital was sued for "negligent credentialing." Claims against hospitals for negligent credentialing are a well-known legal mechanism to establish a separate basis of liability for the hospital where an independent physician's conduct is the main basis of the liability claim.

In Klaine, the defendant, a company that operates a number of hospitals, was sued for negligent credentialing of a staff physician. Among other requests, the plaintiffs sought production of three applications for staff privileges as well as procedure summaries and case histories of surgical procedures performed at various hospitals by the applicant, a staff physician. The court reviewed the defendant's contention that applications for staff privileges are non-discoverable under the Health Care Professional Credentials Data Collect Act, 410 ILCS 517/1 et seq. The defendant also argued that any references to information in the application reported to the National Practitioner Data Bank must be redacted because of a privilege arising under the Health Care Quality Improvement Act of 1986. Additionally, the defendant maintained that information contained within the applications which references medical treatment to patients who were not parties to the lawsuit rendered such information privileged under the Credentials Act and the physician-patient privilege.

The court, noting that the defendant had been sued for "negligent credentialing," determined that the applications were "highly relevant" to that cause of action. In fact, the court noted "we fail to see how a cause of action for negligent credentialing could proceed if we were to deny plaintiffs access to this information." As such, the court concluded that credentialing applications are not privileged. In considering whether information submitted to the National Practitioner Data Bank was privileged, as referenced in the application, the court concluded that the information, "though confidential, is not privileged" where a hospital has been sued and "the hospital's knowledge of information regarding the physician's competence is at issue." Finally, the court noted that so long as the applications do not have "patient identifying" information, it is appropriate to require disclosure of "raw data regarding treatment and procedures performed by [the applicant]."

The Klaine decision will almost certainly lead to an increase in the number of negligent credentialing claims asserted against hospitals.

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