Amendments To The Act
In 1991 Omnibus Budget Reconciliation Act (OBRA) required state medical boards to report "any negative action or finding" by "any peer review or accreditation entity," wresting the notion of peer review by physicians away from the National Practitioner Databank.
In California, this move was echoed as insurance agencies and health plans were enabled to perform "peer review."
This combination of events ended the ability of physicians to conduct peer review of themselves, and "peer review" of physicians became transformed into "performance appraisal" done by physicians and non-physicians alike.
Although the original HCQIA had afforded immunity to physician peer reviewers only (which were originally assumed to constitute the group of peers), the OBRA amendment conferred immunity to a widening circle of non-physician performance appraisers as well.
Read more about this topic: Healthcare Quality Improvement Act
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—Rutherford Birchard Hayes (1822–1893)
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