Tort – Defamation – Peer review privilege

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Where a plaintiff surgeon who was reported to the National Practitioner Data Bank as an immediate threat to the public has alleged defamation and a violation of the Health Care Quality Improvement Act, the complaint must be dismissed because the HCQIA does not create a private cause of action, while the plaintiff’s defamation claim is barred by the Massachusetts peer review privilege.

“This case arises from a November 2022 decision by non-party Bay State Medical Center (‘BMC’) to report Dr. Bejon Maneckshana (‘Plaintiff’) to the National Practitioner Data Bank (‘NPDB’) as an immediate threat to the public. …

“As to Count I, alleging Defendant failed to adhere to the procedural requirements of the HCQIA, Plaintiff does not state a claim as a matter of law. ‘[T]he HCQIA does not create a private cause of action.’ Singh v. Blue Cross/Blue Shield of Massachusetts, Inc., 308 F.3d 25, 45 n. 18 (1st Cir. 2002) (alteration added); see also Garib-Bazain v. Hosp. Espanol Auxilio Mutuo, Inc., 773 F. Supp. 2d 248, 254 (D.P.R. 2011). This court agrees with the conclusion of the Garib-Bazain Court: ‘it is well-settled that the HCQIA does not create an explicit or implicit private cause of action for physicians that are subject to a professional peer review.’ … In the face of this clear precedent and the general rule against implying private causes of action, the court declines any invitation to recognize such a right, as ‘[a] private right of action, like substantive federal law itself, must be created by Congress.’ … Accordingly, Count I is dismissed. …

“Count II, alleging BMC’s report to the NPDB was defamatory, also fails to state claim under Rule 12(b)(6).

“First, Plaintiff’s defamation claim is barred by the Massachusetts peer review privilege. …

“Additionally, while not cited by any party, 42 U.S.C. §11137(c) provides, ‘[n]o person or entity … shall be held liable in any civil action with respect to any report made under this subchapter [to the NPDB] … without knowledge of the falsity of the information contained in the report.’ … Therefore, Section 11137(c) immunity applies unless the complaint raises a plausible inference that the healthcare entity knowingly transmitted a report to the NPDB that did not accurately reflect the nature of the disciplinary action taken against the physician.

“Here, Plaintiff has not alleged facts sufficient to create a plausible inference BMC officials knew they were transmitting a report which falsely reflected the action taken against Plaintiff. Rather, the complaint affirmatively alleges Plaintiff surrendered his privileges under the threat of suspension pending an investigation, an action which must be reported to the NPDB as a matter of federal law. … Count II is therefore barred by Section 11137(c)’s immunity provision.”

Maneckshana v. Baystate Health Inc. (Lawyers Weekly No. 02-226-25) (8 pages) (Mastroianni, J.) (Civil Action No. 24-30097-MGM) (April 16, 2025).

Click here to read the full text of the opinion.