One of the fundamental issues in credentialing disputes is whether the Medical Staff Bylaws constitute contracts between the Hospital and the individual physicians. If the Medical Staff Bylaws do constitute a contract, then the due process provisions contained in the Bylaws are guaranteed to the physician, regardless of the Health Care Quality Immunity Act (HCQIA).
We should note that HCQIA does not mandate due process. Instead, HCQIA merely provides immunity to the Hospital for the credentialing process if it does provide due process. The Hospital could choose to forego the immunity and provide no due process, unless of course due process is provided in the Medical Staff Bylaws and the Medical Staff Bylaws are a contract in that particular jurisdiction.
In Villare v. Beebe Medical Center, the Delaware Superior Court (which is a trial court in Delaware) granted summary judgment to the medical center on the basis that the Medical Staff Bylaws do not constitute a contract in Delaware.
The Delaware Court noted that there is a split among the jurisdictions on this matter, but opted to follow the New York position, which is expressed in the case of Mason v. Central Suffolk Hospital.