1. “adversely affecting”—The term “adversely affecting” includes reducing,
restricting, suspending, revoking, denying, or failing to renew clinical privileges
or membership in a medical care entity.
2. “Board of Medical Examiners”—The term “Board of Medical Examiners”
includes a body comparable to such a Board (as determined by the State) with
responsibility for the licensing of physicians and also includes a subdivision of
such a Board or body.
3. “clinical privileges”—The term “clinical privileges” includes privileges,
membership on the medical staff, and the other circumstances pertaining to the
furnishing of medical care under which a physician or other licensed medical
care practitioner is permitted to furnish such care by a medical care entity.
4. “medical care entity”—The term “medical care entity” means—a hospital that
is licensed to provide medical care services by the State in which it is located,
an entity (including a health maintenance organization or group medical
practice) that provides medical care services and that follows a formal peer
review process for the purpose of furthering quality medical care, a
professional society (or committee thereof) of physicians or other licensed
medical care practitioners that follows a formal peer review process for the
purpose of furthering quality health care. The term “medical care entity” does
not include a professional society (or committee thereof) if, within the previous
5 years, the society has been found by the Federal Trade Commission or any
court to have engaged in any anti- competitive practice which had the effect of
restricting the practice of licensed medical care practitioners.
5. “hospital”—The term “hospital” means an institution which—is primarily
engaged in providing, by or under the supervision of physicians, to inpatients
(A) diagnostic services and therapeutic services for medical diagnosis,
treatment, and care of injured, disabled, or sick persons, or (B) rehabilitation
services for the rehabilitation of injured, disabled, or sick persons. In the case
of an institution in any State in which State or applicable local law provides for
the licensing of hospitals, (A) is licensed pursuant to such law or (B) is
approved, by the agency of such State or locality responsible for licensing
hospitals, as meeting the standards established for such licensing. (42 USCA
6. “licensed medical care practitioner”—The terms “licensed medical care
practitioner” and “practitioner” mean, with respect to a State, an individual
(other than a physician) who is licensed or otherwise authorized by the State
to provide medical care services.
7. “medical malpractice actions or claim”— The term “medical malpractice
action or claim” means a written claim or demand for payment based on a
medical care provider’s furnishing (or failure to furnish) medical care services,
and includes the filing of a cause of action, based on the law of tort, brought in
any court of any State or the United States seeking monetary damages.
8. “physician”—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 by a State (or any individual who, without
authority holds himself or herself out to be so authorized).
9. “professional review activity”—The term “professional review activity” means
an activity of a medical care entity with respect to an individual physician—to
determine whether the physician may have clinical privileges with respect to, or
membership in, the entity, to determine the scope or conditions of such
privileges or membership, or to change or modify such privileges or
10. “professional review body”—The term “professional review body” means a
medical care entity and the governing body or any committee of a medical 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.
11. “Secretary”—The term “Secretary” means the Secretary of Health and
12. “State”—The term “State” means the 50 States, the District of Columbia,
Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern
13. “State Licensing Board”—The term “State licensing board” means, with
respect to a physician or medical care provider in a State, the agency of the
State which is primarily responsible for the licensing of the physician or
provider to furnish medical care services.