(a)   (1)   In this section the following words have the meanings indicated.
    (2)   (i)   "Alternative health care system" means a system of health care
delivery other than a hospital or related institution.
      (ii)   "Alternative health care system" includes:
        1.   A health maintenance organization;
        2.   A preferred provider organization;
        3.   An independent practice association;
        4.   A community health center that is a nonprofit, freestanding ambulatory
health care provider governed by a voluntary board of directors and
that provides primary health care services to the medically indigent;
        5.   A freestanding ambulatory care facility as that term is defined in §
19-3B-01 of the Health - General Article; or
        6.   Any other health care delivery system that utilizes a medical review
committee.
    (3)   "Medical review committee" means a committee or board that:
      (i)   Is within one of the categories described in subsection (b) of this
section; and
      (ii)   Performs functions that include at least one of the functions listed in
subsection (c) of this section.
    (4)   (i)   "Provider of health care" means any person who is licensed by law
to provide health care to individuals.
      (ii)   "Provider of health care" does not include any nursing institution
that is conducted by and for those who rely on treatment by spiritual
means through prayer alone in accordance with the tenets and practices
of a recognized church or religious denomination.
    (5)   "The Maryland Institute for Emergency Medical Services Systems"
means the State agency described in § 13-503 of the Education
Article.
  (b)   For purposes of this section, a medical review committee is:
    (1)   A regulatory board or agency established by State or federal law to
license, certify, or discipline any provider of health care;
    (2)   A committee of the Faculty or any of its component societies or a
committee of any other professional society or association composed of
providers of health care;
    (3)   A committee appointed by or established in a local health department
for review purposes;
    (4)   A committee appointed by or established in the Maryland Institute for
Emergency Medical Services Systems;
    (5)   A committee of the medical staff or other committee, including any risk
management, credentialing, or utilization review committee established
in accordance with § 19-319 of the Health - General Article, of a
hospital, related institution, or alternative health care system, if
the governing board of the hospital, related institution, or
alternative health care system forms and approves the committee or
approves the written bylaws under which the committee operates;
    (6)   A committee or individual designated by the holder of a pharmacy
permit, as defined in § 12-101 of this article, that performs the
functions listed in subsection (c) of this section, as part of a
pharmacy's ongoing quality assurance program;
    (7)   Any person, including a professional standard review organization, who
contracts with an agency of this State or of the federal government to
perform any of the functions listed in subsection (c) of this section;
    (8)   Any person who contracts with a provider of health care to perform any
of those functions listed in subsection (c) of this section that are
limited to the review of services provided by the provider of health
care;
    (9)   An organization, established by the Maryland Hospital Association, Inc.
and the Faculty, that contracts with a hospital, related institution,
or alternative delivery system to:
      (i)   Assist in performing the functions listed in subsection (c) of this
section; or
      (ii)   Assist a hospital in meeting the requirements of § 19-319(e) of the
Health - General Article;
    (10)   A committee appointed by or established in an accredited health
occupations school;
    (11)   An organization described under § 14-501 of this article that
contracts with a hospital, related institution, or health maintenance
organization to:
      (i)   Assist in performing the functions listed in subsection (c) of this
section; or
      (ii)   Assist a health maintenance organization in meeting the requirements of
Title 19, Subtitle 7 of the Health - General Article, the National
Committee for Quality Assurance (NCQA), or any other applicable
credentialing law or regulation;
    (12)   An accrediting organization as defined in § 14-501 of this article;
    (13)   A Mortality Review Committee established under § 5-801 of the Health
- General Article; or
    (14)   A center designated by the Maryland Health Care Commission as the
Maryland Patient Safety Center that performs the functions listed in
subsection (c)(1) of this section.
  (c)   For purposes of this section, a medical review committee:
    (1)   Evaluates and seeks to improve the quality of health care provided by
providers of health care;
    (2)   Evaluates the need for and the level of performance of health care
provided by providers of health care;
    (3)   Evaluates the qualifications, competence, and performance of providers
of health care; or
    (4)   Evaluates and acts on matters that relate to the discipline of any
provider of health care.
  (d)   (1)   Except as otherwise provided in this section, the proceedings, records,
and files of a medical review committee are not discoverable and are
not admissible in evidence in any civil action.
    (2)   The proceedings, records, and files of a medical review committee are
confidential and are not discoverable and are not admissible in
evidence in any civil action arising out of matters that are being
reviewed and evaluated by the medical review committee if requested by
the following:
      (i)   The Department of Health and Mental Hygiene to ensure compliance with
the provisions of § 19-319 of the Health - General Article;
      (ii)   A health maintenance organization to ensure compliance with the
provisions of Title 19, Subtitle 7 of the Health - General Article and
applicable regulations;
      (iii)   A health maintenance organization to ensure compliance with the
National Committee for Quality Assurance (NCQA) credentialing
requirements; or
      (iv)   An accrediting organization to ensure compliance with accreditation
requirements or the procedures and policies of the accrediting
organization.
    (3)   If the proceedings, records, and files of a medical review committee
are requested by any person from any of the entities in paragraph (2)
of this subsection:
      (i)   The person shall give the medical review committee notice by certified
mail of the nature of the request and the medical review committee
shall be granted a protective order preventing the release of its
proceedings, records, and files; and
      (ii)   The entities listed in paragraph (2) of this subsection may not release
any of the proceedings, records, and files of the medical review
committee.
  (e)   Subsection (d)(1) of this section does not apply to:
    (1)   A civil action brought by a party to the proceedings of the medical
review committee who claims to be aggrieved by the decision of the
medical review committee; or
    (2)   Any record or document that is considered by the medical review
committee and that otherwise would be subject to discovery and
introduction into evidence in a civil trial.
  (f)   (1)   A person shall have the immunity from liability described under §
5-637 of the Courts and Judicial Proceedings Article for any action as
a member of the medical review committee or for giving information to,
participating in, or contributing to the function of the medical review
committee.
    (2)   A contribution to the function of a medical review committee includes
any statement by any person, regardless of whether it is a direct
communication with the medical review committee, that is made within
the context of the person's employment or is made to a person with a
professional interest in the functions of a medical review committee
and is intended to lead to redress of a matter within the scope of a
medical review committee's functions.
  (g)   Notwithstanding this section, §§ 14-410 and 14-412 of this article
apply to:
    (1)   The Board of Physicians; and
    (2)   Any other entity, to the extent that it is acting in an investigatory
capacity for the Board of Physicians.
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