HB 371: "An Act relating to medical review organizations; relating to the definitions of 'health care provider' and 'review organization'; and relating to the duties of the chief medical officer in the Department of Health."
00 HOUSE BILL NO. 371 01 "An Act relating to medical review organizations; relating to the definitions of 'health 02 care provider' and 'review organization'; and relating to the duties of the chief medical 03 officer in the Department of Health." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 18.23.030(a) is amended to read: 06 (a) Except as provided in (b), (c), and (e) of this section, all data and 07 information acquired by a review organization in the exercise of its duties and 08 functions shall be held in confidence and may not be disclosed to anyone except to the 09 extent necessary to carry out the purposes of the review organization and is not subject 10 to subpoena or discovery. Except as provided in (b) of this section, a person described 11 in AS 18.23.020 may not disclose what transpired at a meeting of a review 12 organization except to the extent necessary to carry out the purposes of a review 13 organization, and the proceedings and records of a review organization are not subject 14 to discovery or introduction into evidence in a civil action against a health care
01 provider arising out of the matter that is the subject of consideration by the review 02 organization. Information, documents, or records otherwise available from original 03 sources are not immune from discovery or use in a civil action merely because they 04 were presented during proceedings of a review organization, nor may a person who 05 testified before a review organization or who is a member of it be prevented from 06 testifying as to matters within the person's knowledge, but a witness may not be asked 07 about the witness's testimony before a review organization or opinions formed by the 08 witness as a result of its hearings, except as provided in (b) of this section. 09 * Sec. 2. AS 18.23.030 is amended by adding a new subsection to read: 10 (e) A review organization may publish a report containing data or information 11 obtained in the exercise of its duties if the report does not violate federal or state law 12 regarding confidentiality of a person or decedent. A report may include 13 (1) the identification of trends, patterns, and risk factors; 14 (2) an analysis of the rate and cause of death in the state; and 15 (3) methods of intervention or prevention related to causes of death. 16 * Sec. 3. AS 18.23.070(3) is amended to read: 17 (3) "health care provider" means a person licensed, certified, or 18 otherwise permitted by law to provide health care services in the ordinary course 19 of business or practice of a profession, [AN ACUPUNCTURIST LICENSED 20 UNDER AS 08.06; A CHIROPRACTOR LICENSED UNDER AS 08.20; A 21 DENTAL HYGIENIST LICENSED UNDER AS 08.32; A DENTIST LICENSED 22 UNDER AS 08.36; A NURSE LICENSED UNDER AS 08.68; A DISPENSING 23 OPTICIAN LICENSED UNDER AS 08.71; AN OPTOMETRIST LICENSED 24 UNDER AS 08.72; A PHARMACIST LICENSED UNDER AS 08.80; A PHYSICAL 25 THERAPIST OR OCCUPATIONAL THERAPIST LICENSED UNDER AS 08.84; A 26 PHYSICIAN LICENSED UNDER AS 08.64; A PODIATRIST; A PSYCHOLOGIST 27 AND A PSYCHOLOGICAL ASSOCIATE LICENSED UNDER AS 08.86;] a 28 hospital as defined in AS 47.32.900, including a governmentally owned or operated 29 hospital, [;] and an employee of a health care provider acting within the course and 30 scope of employment; 31 * Sec. 4. AS 18.23.070(5) is amended to read:
01 (5) "review organization" means 02 (A) a hospital governing body or a committee whose 03 membership is limited to health care providers and administrative staff, except 04 where otherwise provided for by state or federal law, and that is established by 05 a hospital, by a clinic, by one or more state or local associations of health care 06 providers, by an organization of health care providers from a particular area or 07 medical institution, or by a professional standards review organization 08 established under 42 U.S.C. 1320c-1, to gather and review information relating 09 to the care and treatment of patients for the purposes of 10 (i) evaluating and improving the quality of health care 11 rendered in the area or medical institution; 12 (ii) reducing morbidity or mortality; 13 (iii) obtaining and disseminating statistics and 14 information relative to the treatment and prevention of diseases, illness, 15 and injuries; 16 (iv) developing and publishing guidelines showing the 17 norms of health care in the area or medical institution; 18 (v) developing and publishing guidelines designed to 19 keep the cost of health care within reasonable bounds; 20 (vi) reviewing the quality or cost of health care services 21 provided to enrollees of health maintenance organizations; 22 (vii) acting as a professional standards review 23 organization under 42 U.S.C. 1320c; 24 (viii) reviewing, ruling on, or advising on controversies, 25 disputes, or questions between a health insurance carrier or health 26 maintenance organization and one or more of its insured or enrollees; 27 between a professional licensing board, acting under its powers of 28 discipline or license revocation or suspension, and a health care 29 provider licensed by it when the matter is referred to a review 30 organization by the professional licensing board; between a health care 31 provider and the provider's patients concerning diagnosis, treatment, or
01 care, or a charge or fee; between a health care provider and a health 02 insurance carrier or health maintenance organization concerning a 03 charge or fee for health care services provided to an insured or enrollee; 04 or between a health care provider or the provider's patients and the 05 federal or a state or local government, or an agency of the federal or a 06 state or local government; 07 (ix) acting on the recommendation of a credential 08 review committee or a grievance committee; 09 (B) the State Medical Board established by AS 08.64.010; 10 (C) a committee established by the commissioner of health and 11 approved by the chief medical officer in the Department of Health [STATE 12 MEDICAL BOARD] to review public health issues regarding morbidity or 13 mortality [; AT LEAST 75 PERCENT OF THE COMMITTEE MEMBERS 14 MUST BE HEALTH CARE PROVIDERS]; 15 (D) a nationally recognized group or entity that accredits 16 health care organizations, including the Joint Commission on Accreditation 17 of Healthcare Organizations (JCAHO).