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Swafford v. Memphis Individual Practice Association6/8/1998
Shelby Law No. 54167
APPEAL FROM THE CIRCUIT COURT OF SHELBY COUNTY AT MEMPHIS, TENNESSEE THE HONORABLE ROBERT L. CHILDERS, JUDGE
REVERSED IN PART, AFFIRMED IN PART AND REMANDED
This is a libel suit brought by a physician against a health maintenance organization and related health insurance entities. The trial court granted summary judgment in favor of the defendants based on the statute of limitations. The lawsuit involves allegedly false information reported to the National Practitioner Data Bank. In an issue of first impression, we hold that each dissemination of the allegedly defamatory information by the Data Bank gives rise to a separate cause of action. The grant of summary judgment is affirmed in part and reversed in part, and the cause is remanded.
Plaintiff/Appellant Greg Swafford, M.D. ("Dr. Swafford") is a licensed physician practicing family medicine in Shelby County. Defendant/Appellee Southern Health Plan, Inc. ("Southern") is a federally qualified health maintenance organization operating in Tennessee. Southern hired Defendant/Appellee Memphis Individual Practice Association ("MIPA") to promote, sell, and manage an insurance product known as "The Apple Plan." MIPA is responsible for supervising physicians who treat Apple Plan policyholders in Tennessee. Southern and MIPA may collectively be referred to as "the Defendants."
In February 1990, the parties entered into a contract entitled "MIPA Participating Primary Care Physician Agreement" ("Agreement"). The Agreement required MIPA to refer a specified number of Apple Plan patients to Dr. Swafford and required Dr. Swafford to treat the patients referred to him. The Agreement stated that either party could withdraw from the Agreement upon ninety days' notice.
In early 1991, Dr. Swafford was notified that the Defendants intended to sanction him for substandard care. On April 17, 1991, Dr. Swafford received a notice of termination due to alleged violations of quality of care standards. Dr. Swafford believed that the assertion of substandard care was false, but did not object to his termination.
On August 22, 1991, the Defendants reported Dr. Swafford's termination to the National Practitioner Data Bank ("Data Bank"). The Data Bank operates pursuant to 42 U.S.C.A. §§ 11131, et. seq. (1995), and maintains a data base of information concerning health care providers. Among other requirements, the Act imposes a mandate that all health care entities report adverse professional review actions to the Data Bank. Id. § 11133. Information in the Data Bank is confidential and can be accessed only by health care entities. Id. § 11137(b).
Dr. Swafford alleged that, at the time that the Defendants reported his termination to the Data Bank, he was unaware of the report's existence. In January 1992, Dr. Swafford was notified by the Data Bank that the Defendants had reported that his clinical privileges had been revoked due to violations of quality of care standards. Dr. Swafford was uncertain about the specific number of instances in which health care entities accessed his information from the Data Bank; however, at least three entities have retrieved information from the Data Bank: Baptist Hospital, St. Francis Hospital, and the Tennessee Board of Medical Examiners. None denied clinical privileges to Dr. Swafford. Nevertheless, Dr. Swafford maintains that the existence of the Data Bank report forced him to defend his record to these entities by demonstrating that the charge of substandard care was false. The record does not clearly indicate when each of these health care entities retrieved information from the Data Bank or when Dr. Swafford became aware that th
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