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U.S. Code as of:
01/19/04
Section 645. Confidentiality of medical quality assurance records; qualified immunity for participants
(a) In this section -
(1) "medical quality assurance program" means any activity
carried out by or for the Coast Guard to assess the quality of
medical care, including activities conducted by individuals,
military medical or dental treatment facility committees, or
other review bodies responsible for quality assurance,
credentials, infection control, patient care assessment
(including treatment procedures, blood, drugs, and therapeutics)
medical records, health resources management review and
identification and prevention of medical or dental incidents and
risks.
(2) "medical quality assurance record" means the proceedings,
records, minutes, and reports that emanate from quality assurance
program activities described in paragraph (1) and are produced or
compiled by the Coast Guard as part of a medical quality
assurance program.
(3) "health care provider" means any military or civilian
health care professional who, under regulations prescribed by the
Secretary, is granted clinical practice privileges to provide
health care services in a military medical or dental treatment
facility or who is licensed or certified to perform health care
services by a governmental board or agency or professional health
care society or organization.
(b) Medical quality assurance records created by or for the Coast
Guard as part of a medical quality assurance program are
confidential and privileged. The records may not be disclosed to
any person or entity except as provided in subsection (d).
(c)(1) Medical quality assurance records are not subject to
discovery and may not be admitted into evidence in any judicial or
administrative proceeding, except as provided in subsection (d).
(2) Except as provided in this section, an individual who reviews
or creates medical quality assurance records for the Coast Guard or
who participates in any proceeding that reviews or creates the
records may not testify in any judicial or administrative
proceeding with respect to the records or with respect to any
finding, recommendation, evaluation, opinion, or action taken by
that person in connection with the records.
(d)(1) Subject to paragraph (2), a medical quality assurance
record may be disclosed, and an individual referred to in
subsection (c) may testify in connection with a record only as
follows:
(A) To a Federal executive agency or private organization, if
necessary to license, accredit, or monitor Coast Guard health
care facilities.
(B) To an administrative or judicial proceeding commenced by a
present or former Coast Guard or Coast Guard assigned Public
Health Service health care provider concerning the termination,
suspension, or limitation of clinical privileges of the health
care provider.
(C) To a governmental board or agency or to a professional
health care society or organization, if necessary to perform
licensing, or privileging, or to monitor professional standards
for a health care provider who is or was a member or an employee
of the Coast Guard or the Public Health Service assigned to the
Coast Guard.
(D) To a hospital, medical center, or other institution that
provides health care services, if necessary to assess the
professional qualifications of any health care provider who is or
was a member or employee of the Coast Guard or the Public Health
Service assigned to the Coast Guard and who has applied for or
been granted authority or employment to provide health care
services in or on behalf of the institution.
(E) To an officer, member, employee, or contractor of the Coast
Guard or the Public Health Service assigned to the Coast Guard if
for official purposes.
(F) To a criminal or civil law enforcement agency or
instrumentality charged under applicable law with the protection
of the public health or safety, if a qualified representative of
the agency or instrumentality makes a written request that the
record or testimony be provided for a purpose authorized by law.
(G) In an administrative or judicial proceeding commenced by a
criminal or civil law enforcement agency or instrumentality
referred to in subparagraph (F), but only with respect to the
subject of the proceeding.
(2) Except in a quality assurance action, the identity of any
individual receiving health care services from the Coast Guard or
the identity of any other individual associated with the agency for
the purposes of a medical quality assurance program that is
disclosed in a medical quality assurance record shall be deleted
from that record or document before any disclosure of the record is
made outside the Coast Guard. This requirement does not apply to
the release of information under section 552a of title 5.
(e) Except as provided in this section, a person having
possession of or access to a record or testimony described by this
section may not disclose the contents of the record or testimony.
(f) Medical quality assurance records may not be made available
to any person under section 552 of title 5.
(g) An individual who participates in or provides information to
an individual that reviews or creates medical quality assurance
records is not civilly liable for participating or providing the
information if the participation or provision of information was in
good faith based on prevailing professional standards at the time
the medical quality assurance program activity took place.
(h) Nothing in this section shall be construed as -
(1) authority to withhold from any person aggregate statistical
information regarding the results of Coast Guard medical quality
assurance programs;
(2) authority to withhold any medical quality assurance record
from a committee of either House of Congress, any joint committee
of Congress, or the General Accounting Office if the record
pertains to any matter within their respective jurisdictions;
(3) limiting access to the information in a record created and
maintained outside a medical quality assurance program, including
a patient's medical records, on the grounds that the information
was presented during meetings of a review body that are part of a
medical quality assurance program.
(i) Except as otherwise provided in this section, an individual
who willfully discloses a medical quality assurance record knowing
that the record is a medical quality assurance record, is liable to
the United States Government for a civil penalty of not more than
$3,000 in the case of a first offense and not more than $20,000 in
the case of a subsequent offense.
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