A quality-of-care review conducted by a plaintiff’s health insurance carrier to evaluate an orthopedic surgeon in a medical malpractice action will not be barred from discovery under the Peer Review Protection Act, a trial court judge has ruled.
In an apparent issue of first impression, Lackawanna County Court of Common Pleas Judge Terrence R. Nealon ruled in Venosh v. Henzes that because Blue Cross is not a direct health care practitioner and does not operate a health care facility, it failed to establish that its “quality of care” reviews and peer reviews are protected from discovery pursuant to 63 P.S. Section 425.4. Nealon said that, as written, the act does not apply to health insurance companies or hospital plan corporations. ”The act’s peer review provisions may be extended to health insurance companies or hospital plan corporations only by legislative amendment of that statute,” he said.
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