HB 57: "An Act relating to review organizations and permitting an emergency medical services provider to establish a review organization; and relating to patient records."
00 HOUSE BILL NO. 57 01 "An Act relating to review organizations and permitting an emergency medical services 02 provider to establish a review organization; and relating to patient records." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 18.23.070(1) is amended to read: 05 (1) "administrative staff" means the staff of an agency, institution, or 06 organization that provides health care [A HOSPITAL OR CLINIC]; 07 * Sec. 2. AS 18.23.070(3) is amended to read: 08 (3) "health care provider" means an acupuncturist licensed under 09 AS 08.06; a chiropractor licensed under AS 08.20; a dental hygienist licensed under 10 AS 08.32; a dentist licensed under AS 08.36; a physician or podiatrist licensed 11 under AS 08.64; a nurse licensed under AS 08.68; a dispensing optician licensed 12 under AS 08.71; an optometrist licensed under AS 08.72; a pharmacist licensed under 13 AS 08.80; a physical therapist or occupational therapist licensed under AS 08.84; [A 14 PHYSICIAN LICENSED UNDER AS 08.64; A PODIATRIST;] a psychologist and a
01 psychological associate licensed under AS 08.86; an organization or government 02 agency that is certified or licensed to provide emergency medical services under 03 AS 18.08; a hospital as defined in AS 47.32.900, including a governmentally owned 04 or operated hospital; and an employee of a health care provider acting within the 05 course and scope of employment; 06 * Sec. 3. AS 18.23.070(5) is amended to read: 07 (5) "review organization" means 08 (A) a hospital governing body or a committee whose 09 membership is limited to health care providers and administrative staff, except 10 where otherwise provided for by state or federal law, and that is established by 11 a hospital, by a clinic, by one or more state or local associations of health care 12 providers, by an organization of health care providers from a particular area or 13 medical institution, by an organization or government agency that provides 14 emergency medical services, or by a professional standards review 15 organization established under 42 U.S.C. 1320c-1, to gather and review 16 information relating to the care and treatment of patients for the purposes of 17 (i) evaluating and improving the quality of health care 18 rendered in the area or medical institution; 19 (ii) reducing morbidity or mortality; 20 (iii) obtaining and disseminating statistics and 21 information relative to the treatment and prevention of diseases, illness, 22 and injuries; 23 (iv) developing and publishing guidelines showing the 24 norms of health care in the area or medical institution; 25 (v) developing and publishing guidelines designed to 26 keep the cost of health care within reasonable bounds; 27 (vi) reviewing the quality or cost of health care services 28 provided to enrollees of health maintenance organizations; 29 (vii) acting as a professional standards review 30 organization under 42 U.S.C. 1320c; 31 (viii) reviewing, ruling on, or advising on controversies,
01 disputes, or questions between a health insurance carrier or health 02 maintenance organization and one or more of its insured or enrollees; 03 between a professional licensing board, acting under its powers of 04 discipline or license revocation or suspension, and a health care 05 provider licensed by it when the matter is referred to a review 06 organization by the professional licensing board; between a health care 07 provider and the provider's patients concerning diagnosis, treatment, or 08 care, or a charge or fee; between a health care provider and a health 09 insurance carrier or health maintenance organization concerning a 10 charge or fee for health care services provided to an insured or enrollee; 11 or between a health care provider or the provider's patients and the 12 federal or a state or local government, or an agency of the federal or a 13 state or local government; 14 (ix) acting on the recommendation of a credential 15 review committee or a grievance committee; 16 (B) the State Medical Board established by AS 08.64.010; 17 (C) a committee established by the commissioner of health and 18 approved by the State Medical Board to review public health issues regarding 19 morbidity or mortality; at least 75 percent of the committee members must be 20 health care providers; 21 (D) the Joint Commission on Accreditation of Healthcare 22 Organizations (JCAHO).