Medical Soc. of New Jersey v. Mottola
| Citation | 320 F.Supp.2d 254 |
| Decision Date | 08 June 2004 |
| Docket Number | Civ. No. 04-2126 (WGB). |
| Parties | MEDICAL SOCIETY OF NEW JERSEY, Plaintiff, v. Mary Lou MOTTOLA, Executive Director of the Medical Practitioner Review Panel, and Reni Erdos, Director of the Division of Consumer Affairs, Defendants, and North Jersey Media Group, Inc. d/b/a The Record, Intervener-Defendant. |
| Court | U.S. District Court — District of New Jersey |
Kern Augustine Conroy & Schoppmann, P.C., by Robert J. Conroy, Esq., Bridgewater, NJ, for Plaintiff.
Peter C. Harvey, Attorney General of New Jersey, by Steven N. Flanzman, Esq., Deputy Attorney General, Newark, NJ, for Defendants.
North Jersey Media Group, Inc., by Dina L. Sforza, Esq., Hackensack, NJ, for Intervener-Defendant.
This matter comes before the Court on the motion of plaintiff Medical Society of New Jersey ("MSNJ" or "Plaintiff") for an order enjoining Mary Lou Mottola, Executive Director of the Medical Practitioner Review Panel, and Reni Erdos, Director of the Division of Consumer Affairs, both sued in their official capacities (collectively "Defendants"), from publishing information regarding settlement agreements of malpractice claims entered into by New Jersey doctors. Specifically, Plaintiff's motion seeks two forms of relief from this Court. First, Plaintiff seeks to enjoin Defendants from enforcing the New Jersey Health Care Consumer Information Act, N.J.S.A. § 45:9-22.21, et seq. ("NJHCCIA"), which was enacted by the New Jersey Legislature on June 23, 2003 and is scheduled to become effective June 23, 2004. Second, Plaintiff seeks to enjoin Defendants from disclosing to North Jersey Media Group, Inc., d/b/a The Record ("The Record") certain information contained on medical malpractice payment notices submitted to the State of New Jersey ("the State" or "New Jersey") pursuant to N.J.S.A. § 17:30D-17.
Defendants oppose the motion for preliminary injunction and cross-move to dismiss the Complaint pursuant to Fed.R.Civ.P. 12(b)(1) & (6).
The Record, a daily newspaper with circulation in northern New Jersey, moved to intervene in this action and filed opposition to Plaintiff's request for injunctive relief.
This Court properly exercises jurisdiction over Plaintiff's federal claims pursuant to 28 U.S.C. § 1331. Venue is proper pursuant to 28 U.S.C. § 1391(b).
This Court held oral argument on June 7, 2004 and issued an oral Opinion from the bench as well as a written Order. This Opinion supercedes the Court's oral Opinion on June 7th.
For the reasons stated below, Plaintiff's motion for preliminary injunctive relief is denied. Defendants' motion to dismiss pursuant to Rule 12(b)(1) is denied, and the motion pursuant to Rule 12(b)(6) is granted.
MSNJ was founded in 1766 and is the nation's oldest state society of physicians. Approximately 8,000 physicians hold individual memberships in MSNJ, and MSNJ is one of New Jersey's leading voices representing doctors in the health care field.
MSNJ moves for a preliminary injunction on two distinct grounds. First, MSNJ seeks to enjoin Defendants from enforcing the NJHCCIA, in particular the section mandating that medical malpractice data be made available to the public through the Internet and a toll-free consumer phone line. Second, MSNJ seeks to enjoin Defendants from complying with a March 9, 2004 Order of the Honorable Sybil R. Moses, Assignment Judge, Superior Court of New Jersey, Bergen County, which ordered Defendants to disclose to The Record certain information contained on medical malpractice payment notices submitted to the State Board of Medical Examiners pursuant to New Jersey law.
In 1986, Congress passed the Health Care Quality Improvement Act of 1986 ("HCQIA"), 42 U.S.C. § 11101, et seq. The HCQIA requires that certain information regarding malpractice payments, sanctions, and professional review actions taken with respect to medical professionals be reported to the federal government. 42 U.S.C. §§ 11131-7 (Subchapter II). Specifically, the HCQIA requires that "[e]ach entity (including an insurance company) which makes payment under a policy of insurance, self-insurance, or otherwise in settlement (or partial settlement) of, or in satisfaction of a judgment in, a medical malpractice action or claim shall report ... information respecting the payment and circumstances thereof." 42 U.S.C. § 11131(a). The information reported pursuant to the HCQIA includes:
(4) a description of the acts or omissions and injuries or illnesses upon which the action or claim was based, and
(5) such other information as the Secretary determines is required for appropriate interpretation of information reported under this section.
Id. § 11131(b).
The regulations promulgated pursuant to the HCQIA established the National Practitioner Data Bank ("Data Bank") to collect and organize the reported information as required by the HCQIA. 45 C.F.R. § 60.1. The Data Bank created a centralized clearinghouse for state licensing boards, hospitals and other healthcare entities to obtain relevant background information about physicians. An insurer must, within 30 days of payment, directly report to the Data Bank all medical malpractice payments, including settlements and partial settlements, made with respect to each insured physician. 45 C.F.R. § 60.7.
Hospitals are required to request information from the Data Bank with respect to each physician or health care practitioner who applies for staff membership or clinical privileges. 42 U.S.C. § 11135. Insurance carriers are required not only to make reports to the Data Bank but also to the appropriate state licensing board. 42 U.S.C. § 11134(c); 45 C.F.R. § 60.7. Moreover, the Data Bank makes the information it collects available "to State licensing boards, to hospitals, and to other health care entities (including health maintenance organizations) that have entered (or may be entering) into an employment or affiliation relationship with the physician or practitioner or to which the physician or practitioner has applied for clinical privileges or appointment to the medical staff." 42 U.S.C. § 11137(a).
Section 11137 outlines the confidentiality provisions applicable to the information collected pursuant to the HCQIA. Specifically, the HCQIA mandates:
Information reported under this subchapter is considered confidential and shall not be disclosed (other than to the physician or practitioner involved) except with respect to professional review activity ... or in accordance with regulations of the Secretary promulgated pursuant to subsection (a) of this section. Nothing in this subsection shall prevent the disclosure of such information by a party which is otherwise authorized, under applicable State law, to make such disclosure. Information reported under this subchapter that is in a form that does not permit the identification of any particular health care entity, physician, other health care practitioner, or patient shall not be considered confidential.
42 U.S.C. § 11137(b)(1)(emphasis added). Accordingly, unless otherwise provided by state law, all information collected by the Data Bank and "reported under this subchapter" is presumed confidential and is released only as specifically mandated by the HCQIA.
The Division of Consumer Affairs is a division of the Department of Law and Public Safety of the State of New Jersey. The Medical Practitioner Review Panel ("the Panel") is a component of the Division of Consumer Affairs.1
In 1983, three years before Congress passed the HCQIA, the New Jersey Legislature enacted N.J.S.A. § 17:30D-17, which created reporting requirements similar to those in what would become the HCQIA. The original version of N.J.S.A. § 17:30D-17 required notice of malpractice settlements over $25,000 to be sent to the State Board of Medical Examiners within seven (7) days of settlement. N.J.S.A. 17:30D-17 ().
In 1989, N.J.S.A. § 17:30D-17 was amended and other notable changes were made to the statutory framework. First and foremost, the Panel was created pursuant to N.J.S.A. § 45:9-19.8. The Panel is authorized and required to receive notices from health care facilities or health maintenance organizations detailing actions those entities may take against practitioners, as well as notices "from an insurer or insurance association or a practitioner, ... regarding a medical malpractice claim settlement, judgment or arbitration award or a termination or denial of, or surcharge on, the medical malpractice liability insurance coverage of a practitioner...." N.J.S.A. § 45:9-19.9(a)(1)-(2). The Panel is empowered to investigate all notices and complaints received and to recommend appropriate action to the State Board of Medical Examiners. Id. at 45:9-19.9(c).
The 1989 amendments also changed the reporting requirements outlined in N.J.S.A. § 17:30D-17, which requires insurance companies and individual practitioners to report to the Panel any malpractice claim settlement, judgment or award.
Any insurer or insurance association authorized to issue medical malpractice liability insurance in the State shall notify the Medical Practitioner Review Panel established pursuant to section 8 of P.L.1989, c. 300 (C.45:9-19.8) in writing of any medical malpractice claim settlement, judgment or arbitration award involving any practitioner licensed by the State Board of Medical Examiners and insured by the insurer or insurance association. Any practitioner licensed by the board who is not covered by medical malpractice liability insurance issued in...
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