Sec. 11151. Definitions 

(From the Health Care Quality Act)

(1) The term ''adversely affecting'' includes reducing, 
restricting, suspending, revoking, denying, or failing to renew 
clinical privileges or membership in a health care entity. 

(2) The term ''Board of Medical Examiners'' includes a body 
comparable to such a Board (as determined by the State) with 
responsibility for the licensing of physicians and also includes 
a subdivision of such a Board or body. 

(3) The term ''clinical privileges'' includes privileges, 
membership on the medical staff, and the other circumstances 
pertaining to the furnishing of medical care under which a 
physician or other licensed health care practitioner is permitted 
to furnish such care by a health care entity. 

(A) The term ''health care entity'' means - 
(i) a hospital that is licensed to provide health care 
services by the State in which it is located, 
(ii) an entity (including a health maintenance organization 
or group medical practice) that provides health care services 
and that follows a formal peer review process for the purpose 
of furthering quality health care (as determined under 
regulations of the Secretary), and 
(iii) subject to subparagraph (B), a professional society (or 
committee thereof) of physicians or other licensed health care 
practitioners that follows a formal peer review process for the 
purpose of furthering quality health care (as determined under 
regulations of the Secretary). 
(B) The term ''health care entity'' does not include a 
professional society (or committee thereof) if, within the 
previous 5 years, the society has been found by the Federal Trade 
Commission or any court to have engaged in any anti-competitive 
practice which had the effect of restricting the practice of 
licensed health care practitioners. 

(5) The term ''hospital'' means an entity described in 
paragraphs (1) and (7) of section 1395x(e) of this title. 

(6) The terms ''licensed health care practitioner'' and 
''practitioner'' mean, with respect to a State, an individual 
(other than a physician) who is licensed or otherwise authorized 
by the State to provide health care services. 

(7) The term ''medical malpractice action or claim'' means a 
written claim or demand for payment based on a health care 
provider's furnishing (or failure to furnish) health care 
services, and includes the filing of a cause of action, based on 
the law of tort, brought in any court of any State or the United 
States seeking monetary damages. 

(8) The term ''physician'' means a doctor of medicine or 
osteopathy or a doctor of dental surgery or medical dentistry 
legally authorized to practice medicine and surgery or dentistry 
by a State (or any individual who, without authority holds 
himself or herself out to be so authorized). 

(9) The term ''professional review action'' means an action or 
recommendation of a professional review body which is taken or 
made in the conduct of professional review activity, which is 
based on the competence or professional conduct of an individual 
physician (which conduct affects or could affect adversely the 
health or welfare of a patient or patients), and which affects 
(or may affect) adversely the clinical privileges, or membership 
in a professional society, of the physician. Such term includes 
a formal decision of a professional review body not to take an 
action or make a recommendation described in the previous 
sentence and also includes professional review activities 
relating to a professional review action. In this chapter, an 
action is not considered to be based on the competence or 
professional conduct of a physician if the action is primarily 
based on - 
(A) the physician's association, or lack of association, with 
a professional society or association, 
(B) the physician's fees or the physician's advertising or 
engaging in other competitive acts intended to solicit or 
retain business, 
(C) the physician's participation in prepaid group health 
plans, salaried employment, or any other manner of delivering 
health services whether on a fee-for-service or other basis, 
(D) a physician's association with, supervision of, 
delegation of authority to, support for, training of, or 
participation in a private group practice with, a member or 
members of a particular class of health care practitioner or 
professional, or 
(E) any other matter that does not relate to the competence 
or professional conduct of a physician. 

(10) The term ''professional review activity'' means an 
activity of a health care entity with respect to an individual 
physician - 
(A) to determine whether the physician may have clinical 
privileges with respect to, or membership in, the entity, 
(B) to determine the scope or conditions of such privileges 
or membership, or 
(C) to change or modify such privileges or membership. 

(11) The term ''professional review body'' means a health care 
entity and the governing body or any committee of a health care 
entity which conducts professional review activity, and includes 
any committee of the medical staff of such an entity when 
assisting the governing body in a professional review activity. 

(12) The term ''Secretary'' means the Secretary of Health and 
Human Services. 

(13) The term ''State'' means the 50 States, the District of 
Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, 
and the Northern Mariana Islands. 

(14) The term ''State licensing board'' means, with respect to 
a physician or health care provider in a State, the agency of the 
State which is primarily responsible for the licensing of the 
physician or provider to furnish health care services.