71st OREGON LEGISLATIVE ASSEMBLY--2001 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 213
House Bill 3285
Sponsored by Representatives LOWE, WILLIAMS; Representatives
BACKLUND, BUTLER, GARDNER, HASS, HILL, JENSON, KING, KROPF,
MORGAN, PATRIDGE, SCHRADER, WITT, Senators L BEYER, CARTER,
COURTNEY, DECKERT, HARTUNG, MILLER, MINNIS, YIH
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
Requires Board of Medical Examiners to gather specified
information in order to create individual physician profiles.
Directs board to make profiles available to public in electronic
form.
Requires establishment of hospital internal review boards to
accept and review complaints against physicians. Requires
hospital internal review board to submit findings and conclusions
to Board of Medical Examiners. Imposes civil penalty for failure
to submit findings and conclusions.
Exempts physicians working for Oregon Health Sciences
University from tort limitations.
Requires Health Division study of physician and hospital
comparative performance reports.
A BILL FOR AN ACT
Relating to consumer access to physician information; creating
new provisions; and amending ORS 353.100 and 441.055.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + Sections 2 and 3 of this 2001 Act are added to
and made a part of ORS chapter 677. + }
SECTION 2. { + (1) The Board of Medical Examiners shall create
individual physician profiles for all physicians licensed under
this chapter. Notwithstanding any applicable rules of
confidentiality, a profile created under this section shall
include the following information:
(a) Any felony or serious misdemeanor convictions, or charges
to which a physician pleaded no contest, within the previous 10
years.
(b) Any complaints filed with the board or the Health Division
against the physician within the previous 10 years and the nature
of the complaints.
(c) Any final disciplinary action against the physician by the
board or division within the previous 10 years.
(d) Any final disciplinary action against the physician by a
licensing board in another state within the previous 10 years.
(e) Any complaints filed against the physician with a peer
review committee or internal review board of a hospital within
the previous 10 years, the nature of the complaints and any
disciplinary action taken by the internal review board or
settlement entered into by the internal review board with the
complaining party.
(f) If it occurred within the previous 10 years, any revocation
or involuntary restriction of hospital privileges for reasons
related to competence or character imposed by a hospital's
governing body or any other official of the hospital after
procedural due process has been afforded, or the resignation from
or nonrenewal of medical staff membership, or the restriction of
privileges at a hospital imposed in lieu of or in settlement of a
pending disciplinary case related to competence or character in
that hospital.
(g) Pending malpractice claims and the nature of the claims, as
long as the information disclosed pursuant to this paragraph
contains a statement that the claim is pending and the validity
of the claim has not been proven or disproven.
(h) All medical malpractice court judgments, medical
malpractice arbitration awards and settlements of medical
malpractice claims in which a payment has been awarded to a
complaining party within the previous 10 years, so that the
information:
(A) Is reported in a minimum of three graduated categories
indicating the level of significance of the award or settlement.
(B) Is put in context by comparing an individual physician's
medical malpractice judgment awards and settlements to the
experience of other physicians within the same specialty.
(C) Indicates whether an award or settlement is subject to any
laws limiting tort liability.
(D) Includes, in the case of a settlement, the statement: '
Settlement of a claim may occur for a variety of reasons that do
not necessarily reflect negatively on the professional competence
or conduct of the physician. A payment in settlement of a medical
malpractice action should not be construed as creating a
presumption that medical malpractice has occurred. '
(i) Names of medical schools attended and dates of graduation.
(j) Graduate school education other than medical school, if
any.
(k) Specialty board certificates.
(L) Number of years in practice.
(m) Names of the hospitals where the physician has privileges.
(n) Appointments to medical school faculties and indication
regarding whether the physician has had any responsibility for
graduate medical education within the previous 10 years.
(o) Any publications in peer-reviewed medical literature within
the previous 10 years.
(p) Any professional or community service activities and
awards.
(q) The location of the physician's primary practice setting.
(r) Identification of any translating services that may be
available at the physician's primary practice setting.
(s) Whether the physician participates in Medicaid.
(t) The information required by section 3 of this 2001 Act.
(2) Except as provided by subsection (3) of this section and
notwithstanding ORS 676.175, physician profiles created under
subsection (1) of this section shall be available for release to
the general public from the board. The board is instructed to
make the physician profiles available in an electronic format
accessible by a personal computer.
(3) Prior to the release of a physician profile created under
subsection (1) of this section, the board shall provide a copy of
the profile to the physician who is the subject of the profile
and to any party to a claim, suit, arbitration, settlement or
disciplinary action that is reported in the physician profile.
The board shall allow a reasonable time for the physician or
party to correct any inaccuracies in the profile. Upon the
request of a party, the board shall delete the name and any other
identifying information of the party to a claim, suit,
arbitration, settlement or disciplinary action.
(4) If a physician profile created under subsection (1) of this
section contains information regarding final disciplinary action
against that physician by the Board of Medical Examiners, the
division, other licensing boards or a hospital and the action is
the subject of an appeal by the physician, the information shall
be reported as required but shall contain a note signifying that
the action is the subject of an appeal.
(5) The board shall adopt all rules necessary for the
implementation and administration of this section. The board
shall involve interested organizations, citizen groups and
individuals, including but not limited to malpractice victims, in
a meaningful way in the development of all aspects of the profile
methodology, including collection methods, formatting, and
methods and means for release and dissemination of the
information. Rules adopted to implement and administer this
section shall include rules to protect the confidentiality of
complainants to the greatest extent possible. + }
SECTION 3. { + (1) Any person making a payment under an
insurance policy or in satisfaction, in whole or part, of a
medical malpractice action or claim against a physician licensed
under this chapter, shall report the following information
regarding the payment to the Board of Medical Examiners to be
included in the physician's profile maintained by the board:
(a) The name of the physician whose acts or omissions were the
basis of the action or claim;
(b) The medical field of the physician, including medical
specialty;
(c) The date on which the physician was first licensed in the
medical field;
(d) The number of years the physician has been practicing in
the medical field;
(e) If the physician cannot be identified, then a statement of
such fact and an explanation of the inability to make the
identification as well as the name of the hospital or other
health services organization for whose benefit the payment was
made;
(f) The amount of the payment;
(g) The name of any hospital or health services organization
with which the physician is affiliated or associated;
(h) A statement that describes the acts or omissions and the
illnesses or injuries upon which the action or claim was based;
(i) If the action filed was a class action, the information
should so state; and
(j) At the physician's option, a statement from the physician
regarding the action or claim.
(2) The reporting requirement of subsection (1) of this section
does not apply if:
(a) The payment is made by the physician as a refund of fees
for the health services involved; or
(b) The payment does not exceed the amount of the original
charge for the health services. + }
SECTION 4. { + The clerk of any court in which a physician
licensed under ORS chapter 677 is convicted of any crime shall,
within one week of entry of the conviction, provide to the Board
of Medical Examiners a copy of the judgment of conviction. + }
SECTION 5. { + Section 6 of this 2001 Act is added to and made
a part of ORS 441.015 to 441.063. + }
SECTION 6. { + (1) For purposes of this section, 'physician '
has the meaning given that term in ORS 677.010.
(2) In addition to the peer review committee authorized under
ORS 441.055, all hospitals as described in ORS 442.015 that
employ or admit physicians to practice in the hospital shall
establish an internal review board to accept and review
complaints of inappropriate care or other violations of law or
rules by a physician employed by or admitted to practice in the
hospital.
(3) The internal review board established pursuant to
subsection (2) of this section shall be appointed by the
governing body of the hospital and shall include at least two
nonphysicians who have no affiliation with the hospital.
(4) The internal review board shall submit all findings and
conclusions arising out of a complaint to the Board of Medical
Examiners within 30 days of completion of the conclusions and
findings. Upon the request of the complainant, the submission
under this subsection may omit the name and any other identifying
information about the complainant.
(5) The Health Division shall adopt rules establishing
standards of physician misconduct to be applied by the internal
review board in determining whether to impose sanctions against a
physician. Neither the division nor the internal review board may
require a showing of a pattern of misconduct before the internal
review board may impose sanctions.
(6) The internal review board of a hospital failing to submit
findings and conclusions to the Board of Medical Examiners as
required in subsection (4) of this section shall be subject to
imposition of a civil penalty in an amount not to exceed
$10,000. + }
SECTION 7. ORS 441.055 is amended to read:
441.055. (1) The Health Division and the Senior and Disabled
Services Division shall adopt such rules with respect to the
different types of health care facilities as may be designed to
further the accomplishment of the purposes of ORS 441.015 to
441.087. No rules shall require any specific food { - so - }
{ + as + } long as the necessary nutritional food elements are
present.
(2) Rules describing care given in health care facilities shall
include, but not be limited to, standards of patient care or
patient safety, adequate professional staff organizations,
training of staff for whom no other state regulation exists,
suitable delineation of professional privileges and adequate
staff analyses of clinical records. The appropriate division may
in its discretion accept certificates by the Joint Commission on
Accreditation of Hospitals or the Committee on Hospitals of the
American Osteopathic Association as evidence of compliance with
acceptable standards.
(3) The governing body of each health care facility shall be
responsible for the operation of the facility, the selection of
the medical staff and the quality of care rendered in the
facility. The governing body shall:
(a) Ensure that all health care personnel for whom state
licenses, registrations or certificates are required are
currently licensed, registered or certified;
(b) Ensure that physicians admitted to practice in the facility
are granted privileges consistent with their individual training,
experience and other qualifications;
(c) Ensure that procedures for granting, restricting and
terminating privileges exist and that such procedures are
regularly reviewed to { - assure - } { + ensure + } their
conformity to applicable law;
(d) Ensure that physicians admitted to practice in the facility
are organized into a medical staff in such a manner as to
effectively review the professional practices of the facility for
the purposes of reducing morbidity and mortality and for the
improvement of patient care; and
(e) Ensure that a physician is not denied medical staff
membership or privileges at the facility solely on the basis that
the physician holds medical staff membership or privileges at
another health care facility.
(4) The physicians organized into a medical staff pursuant to
subsection (3) of this section shall propose medical staff bylaws
to govern the medical staff. The bylaws shall include, but not be
limited to the following:
(a) Procedures for physicians admitted to practice in the
facility to organize into a medical staff pursuant to subsection
(3) of this section;
(b) Procedures for ensuring that physicians admitted to
practice in the facility are granted privileges consistent with
their individual training, experience and other qualifications;
(c) Provisions establishing a framework for the medical staff
to nominate, elect, appoint or remove officers and other persons
to carry out medical staff activities with accountability to the
governing body;
(d) Procedures for ensuring that physicians admitted to
practice in the facility are currently licensed by the Board of
Medical Examiners for the State of Oregon;
(e) Procedures for ensuring that the facility's procedures for
granting, restricting and terminating privileges are followed and
that such procedures are regularly reviewed to { - assure - }
{ + ensure + } their conformity to applicable law; and
(f) Procedures for ensuring that physicians provide services
within the scope of the privileges granted by the governing body.
(5) Amendments to medical staff bylaws shall be accomplished
through a cooperative process involving both the medical staff
and the governing body. Medical staff bylaws shall be adopted,
repealed or amended when approved by the medical staff and the
governing body. Approval shall not be unreasonably withheld by
either. Neither the medical staff nor the governing body shall
withhold approval if such repeal, amendment or adoption is
mandated by law, statute or regulation or is necessary to obtain
or maintain accreditation or to comply with fiduciary
responsibilities or if the failure to approve would subvert the
stated moral or ethical purposes of the institution.
(6) The Board of Medical Examiners { - for the State of
Oregon - } may appoint one or more physicians to conduct peer
review for a health care facility upon request of such review by
all of the following:
(a) The physician whose practice is being reviewed.
(b) The executive committee of the health care facility's
medical staff.
(c) The governing body of the health care facility.
(7) The physicians appointed pursuant to subsection (6) of this
section shall be deemed agents of the Board of Medical
Examiners { + , + } { - for the State of Oregon, - } subject
to the provisions of ORS 30.310 to 30.400 and shall conduct peer
review. Peer review shall be conducted pursuant to the bylaws of
the requesting health care facility.
(8) Any person serving on or communicating information to a
peer review committee shall not be subject to an action for
damages for action or communications or statements made in good
faith.
(9) All findings and conclusions, interviews, reports, studies,
communications and statements procured by or furnished to the
peer review committee in connection with a peer review are
confidential pursuant to ORS 192.501 to 192.505 and 192.690 and
all data is privileged pursuant to ORS 41.675.
(10) Notwithstanding subsection (9) of this section, a written
report of the findings and conclusions of the peer review shall
be provided to the governing body of the health care facility who
shall abide by the privileged and confidential provisions set
forth in subsection (9) of this section { + and to the Board of
Medical Examiners pursuant to section 2 of this 2001 Act + }.
(11) Procedures for peer review established by subsections (6)
to (10) of this section are exempt from ORS 183.310 to 183.550.
(12) The Health Division shall adopt by rule standards for
rural hospitals, as defined in ORS 442.470, that specifically
address the provision of care to postpartum and newborn patients
so long as patient care is not adversely affected.
(13) For purposes of this section, 'physician' has the meaning
given the term in ORS 677.010.
SECTION 8. { + The Health Division shall study the benefits to
the citizens of this state of reports that provide comparative
performance and other information regarding physicians and
hospitals and any barriers existing to the production of such
reports. The division shall report to the Seventy-second
Legislative Assembly regarding the merits of such reports and how
the Legislative Assembly may encourage their effective use. In
evaluating reports under this section, the division shall
consider the following:
(1) The appropriate role of this state in developing such
reports and whether physicians and hospitals reasonably can be
expected to develop such reports;
(2) The necessity or advisability of state mandates concerning
the collection and evaluation of information for such reports;
(3) The means and methods for defining and protecting the
reliability and validity of data and information gathered
pursuant to such reports;
(4) The extent to which existing data sources and indicators
are valid; and
(5) The costs of establishing and maintaining systems to
produce such reports and possible sources of revenue to fund the
production of reports. + }
SECTION 9. ORS 353.100 is amended to read:
353.100. (1) The provisions of ORS chapters 35, 190, 192, 244,
281 and 295 and { - ORS 30.260 to 30.460 - } { + ORS 30.260
to 30.268, 30.275 to 30.460 + }, 200.005 to 200.025, 200.045 to
200.090, 236.605 to 236.640, 243.650 to 243.782, 297.040, 307.090
and 307.112 shall apply to Oregon Health Sciences University
under the same terms as they apply to public bodies other than
the state.
(2) Except as otherwise provided by law, the provisions of ORS
chapters 182, 183, 240, 270, 273, 276, 279, 283, 291, 292, 293,
294 and 297 and ORS 180.060, 180.210 to 180.235, 184.305 to
184.345, 190.430, 190.480, 190.490, 192.105, 200.035, 236.380,
243.105 to 243.585, 243.696, 278.011 to 278.120, 278.315 to
278.415, 281.210 to 281.260, 282.010 to 282.150, 357.805 to
357.895 and 656.017 (2) shall not apply to the university.
(3) As a distinct governmental entity, the university shall not
be subject to any provision of law enacted after January 1, 1995,
with respect to any governmental entity, unless the provision
specifically provides that it applies to the university.
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