Opinion ID: 535674
Heading Depth: 4
Heading Rank: 2

Heading: Application of Patrick

Text: 19 Because we conclude that the second prong of the Midcal test is not satisfied, we have no need to address its clear articulation prong. Patrick, 108 S.Ct. at 1663. Appellees' arguments in support of their contention that California actively supervises the peer-review process mirror those made in Patrick. Appellees contend that the State Department of Health Services (SDHS), California Board of Medical Quality Assurance (BMQA), and the state judiciary all actively supervise the peer-review system. 20 The SDHS has substantively the same role in California as the Oregon State Health Division has in Oregon: the licensure and review of hospital procedures, including procedures for the review of staff decisions. 4 Also like the Oregon State Health Division, it has no authority to review privilege decisions and therefore does not actively supervise these procedures. 21 Similarly, the BMQA serves relatively the same role in California as the BOME in Oregon. Its primary function is the regulation and disciplining of physicians. See Cal.Bus. & Prof.Code Secs. 2001-2006 (West Supp.1989). And, as in Oregon, any adverse action taken by a hospital agreement against a member physician must be reported to the BMQA. See Cal.Bus. & Prof.Code Sec. 805 (West Supp.1989). Also like the BOME, the BMQA has no authority to review the outcome of a peer-review proceeding. Although it may not disseminate a report it finds to be without merit, this restriction does not constitute the type of active supervision necessary under Patrick. 22 We join the Supreme Court in avoiding the broad question whether state courts, acting in their judicial capacity, ever can adequately supervise private conduct for purposes of the state action doctrine. See Patrick, 108 S.Ct. at 1664-65. The judicial review that does exist in California does not satisfy the active supervision requirement. 23 Unlike Oregon, California is actively engaged in reviewing peer-review decisions. Such review is created by statute under Cal.Civil Proc.Code Sec. 1094.5 (West Supp.1989) (reviewing quasi-judicial decisions) and Cal.Civ.Proc.Code Sec. 1085 (West 1980) (reviewing quasi-legislative administrative proceedings). 5 The plethora of cases cited by appellees demonstrate the willingness of California courts to entertain challenges to the peer-review process. The function of the trial and appellate courts, however, is limited under both types of proceedings. 24 [Under Section 1094.5,] if the decision was substantively rational, lawful, not contrary to established public policy and the proceedings were fair, a court may not substitute a judgment for that of the governing board even if it disagrees with the board's decision. The scope of review in traditional mandamus proceedings [under section 1085] is limited to an examination of the record of the hospital proceedings to determine whether the action taken was substantively irrational, unlawful or contrary to established public policy or procedurally unfair. 25 Hay v. Scripps Memorial Hosp.-La. Jolla, 183 Cal.App.3d 753, 758, 228 Cal.Rptr. 413, 417 (1986) (citations omitted). This limited form of review is similar to the standards applied by the Oregon courts that the Supreme Court found insufficient to constitute active supervision. Patrick, 108 S.Ct. at 1665. Such constricted review does not convert the action of a private party in terminating a physician's privileges into the action of the State for purposes of the state action doctrine. Id. 26 We therefore find that the California judiciary does not actively supervise the peer-review process. Accordingly, the state action doctrine does not protect peer-review proceedings in California from application of the antitrust laws.