Be it enacted by the Senate and House of Representatives
in General Court assembled, and by the authority of the same,
SECTION 1. Section 6 of chapter 118G of the General Laws, as appearing in section 275 of chapter 151 of the acts of 1996, is hereby amended by adding the following paragraph:-
When collecting information or compiling reports intended to compare individual health care providers, the commission shall require that:-
(a) provider organizations which are representative of the target group for profiling shall be meaningfully involved in the development of all aspects of the profile methodology, including collection methods, formatting and methods and means for release and dissemination;
(b) the entire methodology for collecting and analyzing the data shall be disclosed to all relevant provider organizations and to all providers under review;
(c) data collection and analytical methodologies shall be used that meet accepted standards of validity and reliability;
(d) the limitations of the data sources and analytic methodologies used to develop provider profiles shall be clearly identified and acknowledged, including, but not limited to, the appropriate and inappropriate uses of the data;
(e) to the greatest extent possible, provider profiling initiatives shall use standard-based norms derived from widely accepted, provider-developed practice guidelines;
(f) provider profiles and other information that have been compiled regarding provider performance shall be shared with providers under review prior to dissemination; provided, however, that opportunity for corrections and additions of helpful explanatory comments shall be provided prior to publication; and, provided, further, that such profiles shall only include data which reflect care under the control of the provider for whom such profile is prepared;
(g) comparisons among provider profiles shall adjust for patient case-mix and other relevant risk factors and control for provider peer groups, when appropriate;
(h) effective safeguards to protect against the unauthorized use or disclosure of provider profiles shall be developed and implemented;
(i) effective safeguards to protect against the dissemination of inconsistent, incomplete, invalid, inaccurate or subjective profile data shall be developed and implemented;
(j) the quality and accuracy of provider profiles, data sources and methodologies shall be evaluated regularly;
(k) providers shall be reimbursed for the reasonable costs that are required for assembling, formatting and transmitting data and information to organizations that develop or disseminate provider profiles; and
(l) the benefits of provider profiling shall outweigh the costs of developing and disseminating the profiles.
SECTION 2. Section 53B of chapter 111 of the General Laws, as so appearing, is hereby amended by striking out, in line 13, the word "All" and inserting in place thereof the following words:- Except as provided in section five of chapter one hundred and twelve, all.
SECTION 3. Said section 53B of said chapter 111, as so appearing, is hereby further amended by striking out, in line 32, the word "one" and inserting in place thereof the following word:- ten.
SECTION 4. Section 5 of said chapter 112 of the General Laws, as so appearing, is hereby amended by inserting after the second paragraph the following paragraph:-
The board is hereby authorized and directed to develop and implement, without cost to the commonwealth, a plan for a remediation program designed to improve physicians' clinical and communication skills. The board shall promulgate rules and regulations for such remediation programs which shall include, but not be limited to, the following provisions:
(a) the board shall offer a remediation program to physicians, on a voluntary basis, as an alternative to disciplinary action in appropriate cases as determined by the board;
(b) the board shall select providers of remediation and assessment services for physicians;
(c) the board shall make referrals of physicians to remediation and assessment providers, shall have the authority to approve individual remediation programs recommended by such providers and shall monitor the progress of each physician undertaking a remediation program;
(d) the board shall have the authority to determine successful completion of physician remediation programs and may make any further orders for probationary monitoring, disciplinary proceedings or other action as it deems appropriate;
(e) the board shall negotiate with insurance carriers, hospitals, health care providers, physicians and other affected parties to establish mechanisms for the funding of the remediation programs set forth in this paragraph; provided, however, that said board shall establish terms and conditions under which the primary financial obligation for an individual remediation program shall be borne by the affected physician.
SECTION 5. Said section 5 of said chapter 112, as so appearing, is hereby further amended by inserting after the fourth paragraph the following two paragraphs:-
The board shall collect the following information to create individual profiles on licensees, in a format created by the board that shall be available for dissemination to the public:
(a) a description of any criminal convictions for felonies and serious misdemeanors as determined by the board, within the most recent ten years. For the purposes of this subsection, a person shall be deemed to be convicted of a crime if he pleaded guilty or if he was found or adjudged guilty by a court of competent jurisdiction;
(b) a description of any charges to which a physician pleads nolo contendere or where sufficient facts of guilt were found and the matter was continued without a finding by a court of competent jurisdiction;
(c) a description of any final board disciplinary actions within the most recent ten years;
(d) a description of any final disciplinary actions by licensing boards in other states within the most recent ten years;
(e) a description of revocation or involuntary restriction of hospital privileges for reasons related to competence or character that have been taken by the 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 taken in lieu of or in settlement of a pending disciplinary case related to competence or character in that hospital. Only cases which have occurred within the most recent ten years shall be disclosed by the board to the public;
(f) all medical malpractice court judgments and all medical malpractice arbitration awards in which a payment is awarded to a complaining party during the most recent ten years and all settlements of medical malpractice claims in which a payment is made to a complaining party within the most recent ten years. Dispositions of paid claims shall be reported in a minimum of three graduated categories indicating the level of significance of the award or settlement. Information concerning paid medical malpractice claims shall be put in context by comparing an individual licensee's medical malpractice judgment awards and settlements to the experience of other physicians within the same specialty. Information concerning all settlements shall be accompanied by the following statement: "Settlement of a claim may occur for a variety of reasons which do not necessarily reflect negatively on the professional competence or conduct of the physician. A payment in settlement of a medical malpractice action or claim should not be construed as creating a presumption that medical malpractice has occurred." Nothing herein shall be construed to limit or prevent the board from providing further explanatory information regarding the significance of categories in which settlements are reported.
Pending malpractice claims shall not be disclosed by the board to the public. Nothing herein shall be construed to prevent the board from investigating and disciplining a licensee on the basis of medical malpractice claims that are pending.
(g) names of medical schools and dates of graduation;
(h) graduate medical education;
(i) specialty board certification;
(j) number of years in practice;
(k) names of the hospitals where the licensee has privileges;
(l) appointments to medical school faculties and indication as to whether a licensee has a responsibility for graduate medical education within the most recent ten years;
(m) information regarding publications in peer-reviewed medical literature within the most recent ten years;
(n) information regarding professional or community service activities and awards;
(o) the location of the licensee's primary practice setting;
(p) the identification of any translating services that may be available at the licensee's primary practice location;
(q) an indication of whether the licensee participates in the medicaid program.
The board shall provide individual licensees with a copy of their profiles prior to release to the public. A licensee shall be provided a reasonable time to correct factual inaccuracies that appear in such profile.
A physician may elect to have his profile omit certain information provided pursuant to clauses (l) to (n), inclusive, concerning academic appointments and teaching responsibilities, publication in peer-reviewed journals and professional and community service awards. In collecting information for such profiles and in disseminating the same, the board shall inform physicians that they may choose not to provide such information required pursuant to said clause (l) to (n), inclusive.
SECTION 6. Chapter 221 of the General Laws is hereby amended by striking out section 26 and inserting in place thereof the following section:-
Section 26. The clerk of any court in which a physician registered in the commonwealth is convicted of any crime or in which an unregistered practitioner is convicted of holding himself out as a practitioner of medicine or of practicing medicine shall, within one week thereafter, report the same to the board of registration in medicine together with a copy of the court proceedings in the case. For the purposes of this section, a person shall be deemed to be convicted of a crime if he pleaded guilty or was found or adjudged guilty by a court of competent jurisdiction.
In the instance where a physician pleads nolo contendere to charges or where sufficient facts of guilt were found and the matter was continued without a finding by a court of competent jurisdiction, such clerk shall, within one week thereafter, report the same to the board of registration in medicine together with a copy of the court proceedings in the case.
SECTION 7. The division of health care finance and policy shall conduct a study of reports which provide comparative performance and other information concerning health plans, hospitals, physicians and other providers and shall provide any recommendations it may have for legislation to facilitate the production of such reports and the reasons therefor to the joint committee on health care of the general court on or before March first, nineteen hundred and ninety-seven.
In evaluating such reports and the methodologies used in producing such reports and in developing its recommendations, said division shall consider the following issues:
(a) the appropriate role of the commonwealth in developing such reports, and whether purchasers and providers can reasonably be anticipated to continue to develop such reports in response to market forces;
(b) the necessity or advisability of state mandates concerning the collection and evaluation of information for such reports;
(c) the means and methods for defining and protecting the reliability and validity of data and information including, but not limited to, variations in the relative severity presented by individual patients;
(d) the extent to which existing data sources and indicators are valid; and
(e) the costs of establishing and maintaining systems producing such reports and possible sources of revenue to defray the same.
SECTION 8. On or before December fifteenth, nineteen hundred and ninety-six, the board of registration in medicine shall file a report with the house and senate committees on ways and means concerning the establishment of a funding mechanism for the remediation programs set forth in section four of this act.
SECTION 9. The board of registration in medicine, in implementing the provisions of section five, shall not disseminate a physician profile by electronic media, including the World Wide Web of the Internet, so-called, or on CD-Rom, so-called before May first, nineteen hundred and ninety-seven. The board shall conduct a study of the impact of publication of physician profiles by electronic media on the personal safety of physicians and their families, and shall report its findings to the joint committee on health care on or before January first, nineteen hundred and ninety-seven. The board shall include in such report a sample profile designed with safeguards recommended by the board pursuant to the aforementioned study. Not later than March first, nineteen hundred and ninety-seven and after public hearing, the board shall promulgate regulations to eliminate, to the extent practicable, the possibility that certain information contained in such profiles may jeopardize that personal safety of physicians and their families.