§ 645. — Confidentiality of medical quality assurance records; qualified immunity for participants.
[Laws in effect as of January 24, 2002]
[Document not affected by Public Laws enacted between
January 24, 2002 and December 19, 2002]
[CITE: 14USC645]
TITLE 14--COAST GUARD
PART I--REGULAR COAST GUARD
CHAPTER 17--ADMINISTRATION
Sec. 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.
(Added Pub. L. 102-587, title V, Sec. 5203(a), Nov. 4, 1992, 106 Stat.
5072; amended Pub. L. 104-324, title VII, Sec. 746(b), Oct. 19, 1996,
110 Stat. 3943.)
Prior Provisions
A prior section 645, acts Aug. 4, 1949, ch. 393, Sec. 1, 63 Stat.
547; Sept. 3, 1954, ch. 1263, Sec. 34, 68 Stat. 1239; Aug. 23, 1958,
Pub. L. 85-738, Secs. 4, 5, 72 Stat. 833, provided for settlement of
claims incident to activities of Coast Guard, prior to repeal, effective
two years after Sept. 26, 1968, by Pub. L. 90-525, Sec. 2, Sept. 26,
1968, 82 Stat. 877. See section 2733 of Title 10, Armed Forces.
Amendments
1996--Subsecs. (d) to (h). Pub. L. 104-324 redesignated subsec. (d),
relating to disclosure by person with access to a record or testimony,
as (e) and redesignated former subsecs. (e) to (h) as (f) to (i),
respectively.
