THE OKLAHOMA BAR JOURNAL 44 | SEPTEMBER 2025 Statements or opinions expressed in the Oklahoma Bar Journal are those of the authors and do not necessarily reflect those of the Oklahoma Bar Association, its officers, Board of Governors, Board of Editors or staff. the necessary standards to practice medicine. Credentialing files typically include information related to a health care provider’s qualifications, education, licensure, disciplinary history, insurance information, performance reviews and peer evaluations. Essentially, it is the way for a hospital to verify a physician is competent to provide medical care at its facility. In the context of a medical malpractice lawsuit, a plaintiff may allege that the hospital negligently credentialed or retained a provider with a known history of complications, substandard care or patients’ complaints. However, to support these claims, a party will need access to credentialing documents, which can be requested through discovery. Before a plaintiff can request a health care provider’s credentialing file, they must specifically plead a negligent credentialing claim in the petition. Specifically, under the Oklahoma Peer Review statute, 63 O.S. §1-1709.1(D)(1): In any civil action in which a patient or patient’s legal representative has alleged that the health care entity was independently negligent as a result of permitting the health care professional to provide health care services to the patient in the health care entity, the credentialing and recredentialing data, and the recommendations made and action taken as a result of any peer review process utilized by such health care entity regarding the health care professional prior to the date of the alleged negligence shall be subject to discovery pursuant to the Oklahoma Discovery Code. (Emphasis added.) Thus, after a plaintiff pleads negligent credentialing,15 they need to send a request for production, requesting the credentialing file of the defendant health care provider.16 While the peer review statute allows production of credentialing data, not all documents are discoverable, and health care providers can object to production of the entire files because they can contain peer review and privileged materials – subject to the Oklahoma peer review privilege.17 Not surprisingly, the text of the peer review statute is confusing, and it is not clear exactly which documents in a credentialing file can be withheld from discovery. Under one section of the statute, credentialing and recredentialing data are “peer review information” that is “private, confidential and privileged.”18 And in direct contrast to that section, another section states that credentialing and credentialing data are subject to discovery.19 This will probably be a shocker given the common theme, but there is no specific Oklahoma Supreme Court or Oklahoma Court of Civil Appeals opinion regarding discovery of credentialing files. Therefore, the parties need to be familiar with how the specific district court has previously ruled regarding the discovery of credentialing files. If a defendant health care provider objects to producing a specific portion of the credentialing file, the parties should conduct a meet and confer, and the plaintiff should request a privilege log20 to determine the extent of the privilege and whether it applies. Further, the parties can also request the court to review the credentialing files in camera to determine whether the privilege applies or the documents should be produced. As a general rule, for lack of a better word, the “administrative” credentialing materials – such as the health care provider’s CV or resume, employment history, education history, training, licensure confirmations, criminal history and references – are generally discoverable. These documents confirm a hospital has done its homework to verify a health care provider is educated, trained and licensed to provide medical care. On the other hand, documents related to peer review – such as documents generated during a peer review process,21 disciplinary decisions and/or internal evaluations – are likely privileged and not subject to discovery.22 Also, documents and reports related to the National Practitioner Data Bank (NPDB) are confidential.23 The NPDB is a national archive that includes reports of settlements by physicians in medical malpractice lawsuits. With that said, there is no blanket privilege to the credentialing and peer review documents, which is why a privilege log should be requested. For example, a peer review’s “recommendations made and actions taken” related to peer review of a physician’s care prior to the incident at issue are discoverable. Further, there are exceptions to the peer review privilege, such as medical records and the identity of individuals with knowledge of the facts.24 While there is inherent privilege in the peer review process to allow health care providers to review adverse events without the fear of it being used in litigation, there is also the need for a patient to have these documents when it is alleged that a hospital negligently credentialed a physician. Thus, attorneys
RkJQdWJsaXNoZXIy OTk3MQ==