On April 10, 2009, the Fourth Circuit ruled that a hospital was immune from various state and federal claims under the Health Care Quality Improvement Act (“HCQIA”) for suspending a physician’s privileges without affording him a hearing. Wahi v. Charleston Area Med. Ctr., Inc., No. 06-2162 (4th Cir. Apr. 10, 2009). Affirming the lower court’s grant of summary judgment in favor of the hospital, the Fourth Circuit found that even though it did not hold a formal hearing before issuing the suspension, the hospital provided “other procedures” that were “fair and reasonable … under the circumstances.” Id. While the Court noted that the hospital’s process was “not a recommended model,” the failures in such process, “when viewed in the totality of circumstances against a measuring stick of objective reasonableness,” did not rebut the presumption of immunity under the HCQIA. Id.

Rakesh Wahi, M.D., a licensed cardiologist, was granted privileges at Charleston Area Medical Center (CAMC) in January 1993. In the subsequent years, CAMC temporarily suspended Wahi’s privileges on several occasions, and, as required, made numerous reports to the National Practitioner’s Data Bank (“NPDB”). On July 30, 1999, while investigating allegations that arose during the review of Wahi’s application for reappointment, CAMC summarily suspended Wahi’s privileges in “the best interest of patient care.” His suspension was to continue until resolution of his application for reappointment and any hearing, if requested. On August 26, 1999, the CAMC Credentials Committee subsequently recommended denying Wahi’s application for reappointment and notified Wahi of his right to a hearing regarding the decision.

On September 8, 1999, Wahi requested a hearing regarding both his suspension and the decision not to renew his clinical privileges. Over the next several months, CAMC engaged in discussions regarding Wahi’s access to his files, the composition of the hearing panel and other aspects of the hearing. However, despite frequent requests by CAMC to schedule the hearing, Wahi never provided CAMC with any dates on which he would be available for a hearing. Eventually, all discussions halted and the hearing was never scheduled. On September 13, 1999, CAMC reported Wahi’s suspension to the NPDB and the West Virginia Board of Medicine.

Affirming the district court decision, the Fourth Circuit rejected Wahi’s argument that the hospital was not entitled to immunity under HCQIA because it failed to provide him notice and a hearing. The Fourth Circuit explained that a hospital may qualify for immunity if the review action was taken either “after adequate notice and hearing procedures” or “after such other procedures as are fair to the physician under the circumstances.” Specifically, the Fourth Circuit noted that the hospital put Wahi on notice of the charges against him, notified him of his rights and repeatedly asked him to schedule the hearing. The court further noted that Wahi, who refused to select dates unless the hospital met his preconditions, seemed more intent on forestalling a hearing than on having one.

A copy of the Fourth Circuit’s opinion in Wahi v. Charleston Area Med. Ctr., Inc., No. 06-2162 (4th Cir. Apr. 10, 2009) can be found at http://pacer.ca4.uscourts.gov/opinion.pdf/062162.P.pdf.