Opinion ID: 2260590
Heading Depth: 1
Heading Rank: 1

Heading: violation of state regulation

Text: We address first the assertion that the Hospital's action violated a Department of Human Services regulation. The trial court did not explicitly rule on this issue. Its decision focused instead on whether Dr. Hottentot has a common law cause of action, an issue whose resolution does not determine whether he has a claim for breach of the regulation. The parties have addressed in this Court the substance of the regulation without considering whether a physician may bring a private cause of action to enforce it. We conclude that enforcement is for the Department through licensing sanctions or prosecution, not a private physician in a civil action. Maine statutes require that any person or association operating a hospital obtain a state license. 22 M.R.S.A. § 1811 (1980). Section 1817 permits the Department to condition the license upon meeting Department standards. Section 1820 grants the Department power to establish reasonable standards ... which it finds to be necessary and in the public interest. The Department has in fact adopted regulations whose coverage extends to issues of medical staff qualifications. [2] They require that members of the medical staff be qualified legally, professionally, and ethically for the positions to which they are appointed. The medical staff must have a system, based on definite workable standards, to evaluate each applicant; and privileges must be extended to duly licensed qualified physicians in the appropriate fields... according to individual qualifications. Membership may not be dependent solely upon certification, fellowship, or membership in a specialty, body or society. Instead, [a]ll qualified candidates [must be] considered by the credentials committee. In the specific provision pointed to by Dr. Hottentot, the regulation requires that [c]riteria for selection are individual character, competence, training, experience, and judgment. Dr. Hottentot emphasizes the use of the word individual in the regulation, and maintains that a blanket requirement of eligibility for the ABS examination eliminates consideration of his individual characteristics. This argument is not persuasive. Obviously the Department did not intend to prohibit all credentials requirements (such as graduation from a medical school) and require a hospital to assess each applicant's medical knowledge independently of education and training. See Hull v. Board of Commissioners of Halifax Hospital Medical Center, 453 So.2d 519, 523 (Fla.Dist.Ct. App.1984) (statutory requirement of consideration on an individual basis requires only that uniform standards be applied equally). We are more troubled by the import of the Department's outright prohibition of criteria dependent solely upon certification... in a specialty body like the ABS. Neither party sheds any light on the scope of this provision and whether Rule D-1 is consistent with it. Whatever its scope, however, the regulation is adopted pursuant to a licensing program. The sanction provided by statute for failure to comply with Department regulations is to make the hospital's license temporary or conditional and ultimately suspend or revoke it if necessary. 22 M.R. S.A. § 1817 (1980). In addition, criminal penalties are explicitly provided for violation of the Department's regulations. Id. at § 1821. We have stated in Larrabee v. Penobscot Frozen Foods, Inc., 486 A.2d 97, 101 (Me.1984), that we will recognize a private cause of action to enforce a statute only where the legislative intent to create such a remedy is clear. The same standard should apply to enforcement of regulations, and we see no such intent here. Instead the Legislature has clearly enumerated the sanctions: license conditions and suspensions and criminal penalties. Accordingly, if there has been any violation of the licensing standards, Dr. Hottentot should address his complaint to the Department rather than the courts.