---
kind: "section"
citation: "42 U.S.C. § 11112"
title: "42"
title_heading: "The Public Health and Welfare"
number: "11112"
heading: "Standards for professional review actions"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/11112"
units:
  - "Chapter 117 — Encouraging Good Faith Professional Review Activities"
  - "Subchapter I — Promotion of Professional Review Activities"
---

# §11112. Standards for professional review actions

- (a) **In general—** For purposes of the protection set forth in [section 11111(a) of this title](/usc/42/11111.md?p=a), a [professional review action](/usc/42/11151.md?p=9) must be taken—
  - (1) in the reasonable belief that the action was in the furtherance of quality health care,
  - (2) after a reasonable effort to obtain the facts of the matter,
  - (3) after adequate notice and hearing procedures are afforded to the [physician](/usc/42/11151.md?p=8) involved or after such other procedures as are fair to the [physician](/usc/42/11151.md?p=8) under the circumstances, and
  - (4) in the reasonable belief that the action was warranted by the facts known after such reasonable effort to obtain facts and after meeting the requirement of [paragraph (3)](#a-3).

  A [professional review action](/usc/42/11151.md?p=9) shall be presumed to have met the preceding standards necessary for the protection set out in [section 11111(a) of this title](/usc/42/11111.md?p=a) unless the presumption is rebutted by a preponderance of the evidence.

- (b) **Adequate notice and hearing—** A [health care entity](/usc/42/11151.md?p=4-A) is deemed to have met the adequate notice and hearing requirement of [subsection (a)(3)](#a-3) with respect to a [physician](/usc/42/11151.md?p=8) if the following conditions are met (or are waived voluntarily by the [physician](/usc/42/11151.md?p=8)):
  - (1) **Notice of proposed action—** The [physician](/usc/42/11151.md?p=8) has been given notice stating—
    - (A)
      - (i) that a [professional review action](/usc/42/11151.md?p=9) has been proposed to be taken against the [physician](/usc/42/11151.md?p=8),
      - (ii) reasons for the proposed action,
    - (B)
      - (i) that the [physician](/usc/42/11151.md?p=8) has the right to request a hearing on the proposed action,
      - (ii) any time limit (of not less than 30 days) within which to request such a hearing, and
    - (C) a summary of the rights in the hearing under [paragraph (3)](#b-3).
  - (2) **Notice of hearing—** If a hearing is requested on a timely basis under [paragraph (1)(B)](#b-1-B), the [physician](/usc/42/11151.md?p=8) involved must be given notice stating—
    - (A) the place, time, and date, of the hearing, which date shall not be less than 30 days after the date of the notice, and
    - (B) a list of the witnesses (if any) expected to testify at the hearing on behalf of the [professional review body](/usc/42/11151.md?p=11).
  - (3) **Conduct of hearing and notice—** If a hearing is requested on a timely basis under [paragraph (1)(B)](#b-1-B)—
    - (A) subject to [subparagraph (B)](#b-3-B), the hearing shall be held (as determined by the [health care entity](/usc/42/11151.md?p=4-A))—
      - (i) before an arbitrator mutually acceptable to the [physician](/usc/42/11151.md?p=8) and the [health care entity](/usc/42/11151.md?p=4-A),
      - (ii) before a hearing officer who is appointed by the entity and who is not in direct economic competition with the [physician](/usc/42/11151.md?p=8) involved, or
      - (iii) before a panel of individuals who are appointed by the entity and are not in direct economic competition with the [physician](/usc/42/11151.md?p=8) involved;
    - (B) the right to the hearing may be forfeited if the [physician](/usc/42/11151.md?p=8) fails, without good cause, to appear;
    - (C) in the hearing the [physician](/usc/42/11151.md?p=8) involved has the right—
      - (i) to representation by an attorney or other person of the [physician](/usc/42/11151.md?p=8)’s choice,
      - (ii) to have a record made of the proceedings, copies of which may be obtained by the [physician](/usc/42/11151.md?p=8) upon payment of any reasonable charges associated with the preparation thereof,
      - (iii) to call, examine, and cross-examine witnesses,
      - (iv) to present evidence determined to be relevant by the hearing officer, regardless of its admissibility in a court of law, and
      - (v) to submit a written statement at the close of the hearing; and
    - (D) upon completion of the hearing, the [physician](/usc/42/11151.md?p=8) involved has the right—
      - (i) to receive the written recommendation of the arbitrator, officer, or panel, including a statement of the basis for the recommendations, and
      - (ii) to receive a written decision of the [health care entity](/usc/42/11151.md?p=4-A), including a statement of the basis for the decision.

  A [professional review body](/usc/42/11151.md?p=11)’s failure to meet the conditions described in this subsection shall not, in itself, constitute failure to meet the standards of [subsection (a)(3)](#a-3).

- (c) **Adequate procedures in investigations or health emergencies—** For purposes of [section 11111(a) of this title](/usc/42/11111.md?p=a), nothing in this section shall be construed as—
  - (1) requiring the procedures referred to in [subsection (a)(3)](#a-3)—
    - (A) where there is no adverse [professional review action](/usc/42/11151.md?p=9) taken, or
    - (B) in the case of a suspension or restriction of [clinical privileges](/usc/42/11151.md?p=3), for a period of not longer than 14 days, during which an investigation is being conducted to determine the need for a [professional review action](/usc/42/11151.md?p=9); or
  - (2) precluding an immediate suspension or restriction of [clinical privileges](/usc/42/11151.md?p=3), subject to subsequent notice and hearing or other adequate procedures, where the failure to take such an action may result in an imminent danger to the health of any individual.

## Source credit

(Pub. L. 99–660, title IV, § 412, Nov. 14, 1986, 100 Stat. 3785.)