[Code of Federal Regulations]
[Title 38, Volume 2]
[Revised as of July 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR46.1]

[Page 814-815]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
          CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS (CONTINUED)
 
PART 46--POLICY REGARDING PARTICIPATION IN NATIONAL PRACTITIONER DATA BANK
--Table of Contents
 
                      Subpart A--General Provisions
 
Sec. 46.1  Definitions.


    (a) Act means The Health Care Quality Improvement Act of 1986, as 
amended (42 U.S.C. 11101-11152).
    (b) Claim of medical malpractice means a written claim or demand for 
payment based on an act or omission of a physician, dentist, or other 
health care practitioner in furnishing (or failing to furnish) health 
care services, and includes the filing of a complaint or administrative 
tort claim under the Federal Tort Claims Act, 28 U.S.C. 1346(b), 2671-
2680.
    (c) Clinical privileges means privileges granted by a health care 
entity to individuals to furnish health care.
    (d) Dentist means a doctor of dental surgery or dental medicine 
legally authorized to practice dental surgery or dentistry by a State 
(or any individual who holds himself or herself out to be so 
authorized).
    (e) Director means the duly appointed director of a Department of 
Veterans Affairs health care facility or any individual with 
authorization to act for that person in the director's absence.
    (f) Gross negligence is materially worse than substandard care, and 
consists of an entire absence of care, or an absence of even slight care 
or diligence; it implies a thoughtless disregard of consequences or 
indifference to the rights of others.
    (g) Health care facility means a hospital, domiciliary, outpatient 
clinic, or any other entity that provides health care services.
    (h) Other health care practitioner means an individual other than a 
physician or dentist who is licensed or otherwise authorized by a State 
to provide health care services.
    (i) Physician means a doctor of medicine or osteopathy authorized to 
practice medicine or surgery by a State (or any individual who holds 
himself or herself out to be so authorized).
    (j) Professional review action means a recommendation by a 
professional review panel (with at least a majority vote) to affect 
adversely the clinical privileges of a physician or dentist taken as a 
result of a professional review activity based on the competence or 
professional conduct of an individual physician or dentist in cases in 
which such conduct affects or could affect adversely the health or 
welfare of a patient, or patients. An action is not considered to be 
based on the competence or professional conduct of a physician or 
dentist, if the action is primarily based on:
    (1) A physician's or dentist's association with, administrative 
supervision of, delegation of authority to, support for, or training of, 
a member or members of a particular class of health care practitioner or 
professional, or
    (2) Any other matter that does not relate to the competence or 
professional conduct of a physician or dentist in his/her practice at a 
Department of Veterans Affairs health care facility.
    (k) Professional review activity means an activity with respect to 
an individual physician or dentist to establish a recommendation 
regarding:
    (1) Whether the physician or dentist may have clinical privileges 
with respect to the medical staff of the facility;

[[Page 815]]

    (2) The scope or conditions of such privileges or appointment; or
    (3) Change or modification of such privileges.
    (l) State means the fifty States, the District of Columbia, Puerto 
Rico, the Virgin Islands, Guam, American Samoa, the Northern Mariana 
Islands, and any other territories or possessions of the United States.
    (m) State Licensing Board means, with respect to a physician, 
dentist, or other health care practitioner in a State, the agency of the 
State, which is primarily responsible for the licensing of the 
physician, dentist, or practitioner to furnish health care services.
    (n) Willful professional misconduct means worse than mere 
substandard care, and contemplates the intentional doing of something 
with knowledge that it is likely to result in serious injuries or in 
reckless disregard of its probable consequences.