HB 500(title am)-DEFINITION OF MEDICAL REVIEW ORGANIZATION  CHAIR DYSON announced the next order of business to be HB 500(title am). SARA NIELSON, staff to Representative Ralph Samuels, described HB 500 as a simple bill. She paraphrased from the sponsor statement as follows: House Bill 500 simply adds the Joint Commission on Accreditation of Health Care Organizations (JCAHO) to the narrow definition of a "review organization." The Joint Commission on Accreditation of Health Care Organizations is the principle independent organization that performs accreditation of hospitals throughout the United States, including Alaska. JCAHO recently implemented a new program requiring hospitals to undergo a Periodic Performance Review (PPR) to achieve continuous standards compliance, and thus, continuous provision of safe, high-quality health care. The current statute defines a "review organization" expressly and narrowly and is silent as to the major organization conducting hospital accreditation in our state, [which is] JCAHO. Without the change in this legislation, a party in an unrelated civil action, could argue vigorously that JCAHO is well known within the health care community as the primary accreditation instrument for hospitals in the United States, and that it would have been a very easy matter for the legislation to have included it in the definition of a "review organization." It could be asserted that the courts have no business re-writing statutes to include provisions that it thinks the legislature would have included if it had thought of it at the time that provision was enacted. Thus, there is a very real danger that information provided to JCOHO as part of this process would not be treated as confidential. This legislation is necessary so that hospitals will feel free to fully report all the information required by JCAHO in an open manner and promote quality health care in Alaska. CHAIR DYSON asked whether the administration supported the bill. MS. NIELSON said she didn't believe they had a position, but Janet Clarke could respond. JANET CLARKE, Department of Health & Social Services representative, said they support quality health care and quality assurance for health care facilities, but she was unaware of any public position paper on the legislation. She continued to say, "We run a hospital that is covered by the Joint Commission Review. We have hospital certification and licensing and anything that could promote that we would support." CHAIR DYSON asked if the organization is credible. MS. CLARKE replied they are extremely credible. CHAIR DYSON asked what the legislation would allow that can't be done now. MS. CLARKE didn't know of anything, but right now it could be argued that confidentiality is in question because JCAHO isn't mentioned as a review organization. CHAIR DYSON asked Laurie Herman to comment. LAURIE HERMAN, Regional Director of Government Affairs for Providence Health System in Alaska, testified via teleconference. To demonstrate why they believe this legislation is necessary she explained: Recently JCAHO redesigned their survey process from being a once-every-three-year survey to one that requires hospitals and other health care organizations to complete a mid-cycle performance review the purpose of which is to review and make certain that we are achieving continuous standards of compliance and continuous provision of safe, high quality health care. In addition to the requirement of self-reporting of deficiencies, this performance review process requires that a hospital or health care organization complete an in-depth survey of their policies and procedures. If the hospital is found to be out of compliance with accepted standards in any area, an attended corrective plan has to be submitted to JCAHO. And JCAHO prefers implementation of both the review and the self- reporting deficiency to be in an electronic online communication. To the extent that anyone would have deficiencies, as part of this process they must prepare and post the corrective action plans. Because of the concern that state statutes do not specifically include JCAHO as a quality review organization, which would thereby protect the reporting information from public accessibility, they may go to a less preferred option that would allow such organizations to simply certify that they made corrections on their own without providing any information to JCAHO. We believe that the quality of health care would improve if health care organizations feel free to fully report all the information required by JCAHO in an open manner. CHAIR DYSON asked if she had any idea why JHACO wasn't included in the statutory language. MS. HERMAN said there aren't any specific organizations that are mentioned in current statute. The language is quite vague, which makes it arguable that since they aren't mentioned then the information should be accessible to the public. That could certainly deter reporting and/or lead to self-analysis. There was no further testimony, questions or comments. CHAIR DYSON asked for a motion. SENATOR GREEN motioned to report HB 500(title am) from committee with individual recommendations and accompanying fiscal notes. There being no objection, it was so ordered.