HB156.html

Said chapter is further amended by striking Code Section 31_7_133, relating to the confidentiality of review organizations´ records, and inserting in its place the following:
"31_7_133.
(a) Except in proceedings alleging violation of this article, the proceedings and records of a review organization shall be held in confidence and shall not be subject to discovery or introduction into evidence in any civil action; and no person who was in attendance at a meeting of such organization shall be permitted or required to testify in any such civil action as to any evidence or other matters produced or presented during the proceedings or activities of such organization or as to any findings, recommendations, evaluations, opinions, or other actions of such organization or any members thereof. The confidentiality provisions of this article shall also apply to any proceedings, records, actions, activities, evidence, findings, recommendations, evaluations, opinions, data, or other information shared between review organizations which are performing a peer review function or disclosed to a governmental agency as required by law. However, information, documents, or records otherwise available from original sources are not to be construed as immune from discovery or use in any such civil action merely because they were presented during proceedings of such organization, nor should any person who testifies before such organization or who is a member of such organization be prevented from testifying as to matters within such person´s knowledge; but such witness cannot be asked about such witness´s testimony before such organization or about opinions formed by such witness as a result of the organization hearings. Notwithstanding the foregoing, the Department of Human Resources may inspect and copy peer review materials maintained by certain providers when it is determined by the department to be necessary in the performance of the department´s licensure and certification responsibilities under Code Section 31_7_15; provided, however, such inspection and copying shall not waive or abrogate the confidentiality of such peer review materials as set forth in this Code section and in Code Section 31_7_15.
(b) This Code section shall not apply to prevent:
(1) The disclosure under Article 4 of Chapter 18 of Title 50 of those documents in the department´s custody which are records, reports, or recommendations of the Joint Commission on Accreditation of Healthcare Organizations or other national accreditation body and which are provided by an institution to the department for licensure purposes under subsection (b) of Code Section 31_7_3;
(2) The use of ~~such~~ peer review documents in any proceeding involving the permitting or licensing of an institution pursuant to this chapter to the extent necessary to challenge the effectiveness of the institution´s peer review system; provided, however, such use shall not waive or abrogate the confidentiality of such documents as set forth in this Code section and in Code Section 31_7_15; or
(3) A health care provider from obtaining the specific reasons and the records and proceedings related to such provider´s exclusion or termination as a participating provider in a health maintenance organization, provider network, or other organization which engages in managed care if such provider has brought a civil action against such health maintenance organization, provider network, or other organization for wrongful exclusion or termination."

43-34A-1.
This chapter shall be known and may be cited as the 'Patient Right to Know Act of 2001.'

43-34A-2.
As used in this chapter, the term:
(1) 'Board' means the Composite State Board of Medical Examiners.
(2) 'Current' means within the last six months.
(3) 'Disciplinary action' means any final hospital disciplinary action or any final disciplinary action taken by the Composite State Board of Medical Examiners under subsection (b) of Code Section 43-34-37 within the immediately preceding ten_year period. No such disciplinary action taken prior to the effective date of this chapter shall be included within the definition of this term.
(4) 'Hospital' means a facility that provides inpatient and outpatient care and services for the diagnosis and treatment of medical conditions.
(5) 'Hospital privileges' means permission granted by a hospital to a physician to treat patients in that hospital.

43-34A-3.
(a) The Composite State Board of Medical Examiners shall create physician profiles on each physician licensed to practice in this state under Chapter 34 of this title.
(b) In creating physician profiles, the board shall by regulation establish a standard form for the collection and dissemination of such data to the public, including dissemination on the Internet. The information may be gathered from the physician, the board, medical malpractice insurers, hospitals, medical and speciality societies, and other appropriate sources. The information shall be compiled in a form which can be disseminated to a member of the public upon request. Additionally, the board shall include in a physician´s profile comments submitted by the physician regarding information published in the physician´s profile. Such comments shall not exceed 100 words. The physician shall have 30 days to submit comments from the date of receipt of the profile or any amended profile if the amendment relates to malpractice, hospital staff privileges or disciplinary action.
(c) The physician profile shall include the following information:
(1) The full name of the physician;
(2) Names of medical schools attended, dates of attendance, and date of graduation;
(3) The location and dates of graduate medical education;
(4) Speciality board certification, if applicable. The toll-free number of the American Board of Medical Specialities shall be included to verify current board certification status;
(5) The fact that a license has been granted by reciprocity under Code Section 43-34-31, if applicable;
(6) The number of years in practice and locations;
(7) Current hospital privileges;
(8) The location of primary practice setting;
(9) If requested by the physician, identification of any translating services available at the primary practice setting;
(10) Participation in the Medicaid program, if applicable;
(11) Criminal convictions for felonies, irrespective of the pendency or availability of an appeal;
(12) Felony charges to which a plea of nolo contendere was entered;
(13) A description of any final, public disciplinary action by a regulatory board and a description of any second or subsequent final private reprimand by a regulatory board. As used in this paragraph, the term 'regulatory board' refers to:
(A) The Composite State Board of Medical Examiners and its counterpart in any other state; and
(B) Any state licensing board in Georgia or in any other state;
(14) A description of any final revocation or any final disciplinary action resulting in any restriction of hospital privileges, either involuntary or by agreement, for reasons related to competence or character in the most recent ten years. No such revocation or restriction taken prior to the effective date of this chapter shall be included in the physician´s profile;
(15) Resignation from or nonrenewal of medical staff membership or the restriction of staff privileges at a hospital taken in lieu of or in settlement of pending disciplinary action related to competence or character in the most recent ten years. No such action taken prior to the effective date of this chapter shall be included in the physician´s profile;
(16) Final medical malpractice court judgments or medical malpractice arbitration awards entered on or after the effective date of this chapter in which payment in excess of $100,000.00 is awarded against the physician to the complaining party. No such judgments or awards prior to the effective date of this chapter shall be included in any physician´s profile. No such medical malpractice court judgments or medical malpractice arbitration awards which occurred more than ten years prior to the date of the profile shall be included in any physician profile;
(17)(A) Medical malpractice settlements, including the monetary amount of each such settlement, in which payment in excess of $300,000.00 is made by or on behalf of and attributable to the physician to the complaining party. No such settlement occurring prior to the effective date of this chapter shall be included in any physician profile. No such settlement which occurred more than ten years prior to the date of the profile shall be included in any physician profile.
(B) Medical malpractice settlements, including the monetary amount of each such settlement, if three medical malpractice settlements have been made by or on behalf of and attributable to the physician to the complaining party and payment in excess of $100,000.00 has been made by or on behalf of and attributable to the physician in any one or more of such settlements. No such settlement occurring prior to the effective date of this chapter shall be included in any physician profile nor shall any such settlement be included for the purpose of determining whether three medical malpractice settlements have been made by or on behalf of and attributable to the physician. No such settlement which occurred more than ten years prior to the date of the profile shall be included in any physician profile nor shall any such settlement be included for the purpose of determining whether three medical malpractice settlements have been made by or on behalf of and attributable to the physician.
(C) All medical malpractice settlements, including the monetary amount of each such settlement, if four or more medical malpractice settlements have been made by or on behalf of and attributable to the physician to the complaining party, regardless of the amount of the payment made by or on behalf of and attributable to the physician in any such settlement. No such settlement occurring prior to the effective date of this chapter shall be included in any physician profile nor shall any such settlement be included for the purpose of determining whether four or more medical malpractice settlements have been made by or on behalf of and attributable to the physician. No such settlement which occurred more than ten years prior to the date of the profile shall be included in any physician profile nor shall any such settlement be included for the purpose of determining whether four or more medical malpractice settlements have been made by or on behalf of and attributable to the physician.
(D) Any disclosure under this paragraph 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.';
(18) Pending malpractice claims shall not be disclosed;
(19) The board may, in its discretion, include additional statements describing the experience or pattern of awards, judgments, or settlements of the physician. Information concerning paid medical malpractice claims may be put in context by comparing an individual licensee´s medical malpractice judgments, awards, or settlements to the experience of other physicians within the same specialty;
(20) Any complaint or grievance filed with the board and upon which the board took disciplinary action, including a description of the nature of the complaint and the resolution; and
(21) All violations of this chapter.
(d) The physician profile may include information relating to:
(1) Appointment to medical school faculties within the most recent ten years;
(2) Articles in professional publications and journals; and
(3) Professional or community service membership, activities, and awards.
(e) The physician profiles shall be updated by the board as required in this subsection:
(1) The profile items listed in paragraphs (11) through (17) of subsection (c) of this Code section inclusive shall be reported to the board by the physician involved within ten days of the judgment, award, settlement, revocation, resignation, or disciplinary action, and the board shall update the physician´s profile with such changes within ten days of receipt of such information; and
(2) All other changes to the physician profile shall be reported by the physician to the board within 30 days of the change, and the board shall verify and update the physician profile with such new information within 15 days.
(f) The physician may request a copy of the profile and may submit corrections to the board. The board shall verify corrections and make changes to the profile within five business days of receipt of the corrected information by the board. The physician may request postcorrection publication by the board to whomever received the profile containing the error.
(g) Notwithstanding the provisions of subsection (c) of this Code section, no final medical malpractice court judgment, medical malpractice arbitration award, or medical malpractice settlement which was awarded prior to the effective date of this chapter and which was sealed by order of a court prior to the effective date of this chapter shall be required to be disclosed pursuant to subsection (c) of this Code section. No final medical malpractice court judgment, medical malpractice arbitration award, or medical malpractice settlement which is awarded on or after the effective date of this chapter shall be confidential or sealed with regard to information which is needed to comply with the purposes of this chapter.

43-34A-4.
Any person or entity has the right to receive a physician profile from the board upon request. Requests for physician profiles shall be accepted by the board by telephone, in writing, or by electronic mail. The person or entity requesting the profile shall provide the name of the physician for whom a profile is sought. The board may charge a nominal fee for copying as is permitted under subsection (c) of Code Section 50-18-71. The board shall not require the person or entity requesting a physician´s profile to use a specific request form or provide a statement of reason for requesting the profile. The board shall not be required to prepare reports, summaries, or compilations of profiles not in existence at the time of the request. The board shall keep both the identity of the person or entity who requests a physician´s profile and the request confidential. The board must respond to all requests within three business days by sending a copy of the physician profile to the requester. Fees may be charged in accordance with subsection (c) of Code Section 50_18_71. A physician may make available his or her current unaltered board approved profile to the patients in his or her practice. The physician may not knowingly disperse a profile that does not disclose recent disciplinary actions, criminal convictions, revocations or restriction of hospital privileges, settlements, medical malpractice judgments, or arbitration awards as set forth in paragraphs (11) through (17) of subsection (c) of Code Section 43_34A_3.

43-34A-5.
A patient has the right to inquire as to the estimated charges for a routine office visit, routine treatments, and lab tests prior to receiving such treatment. When asked for such information, the physician or other authorized personnel shall give such information freely and without reservation or evasion. Violation of this right should be reported immediately to the board. Physicians are not responsible for ascertaining the details of the patient´s insurance coverage and explaining such information to the patient. A physician may require the payment of his or her fee or any applicable copayment in advance of delivering professional services unless otherwise prohibited by law.

43-34A-6.
(a) The patient or any person that the board deems to have a legitimate interest has the right to file a grievance with the board concerning a physician, staff, office, or treatment received.
(b) A declaration of the patient´s rights shall be prominently displayed in conspicuous language in the physician´s waiting room. This declaration may be contained in the same notice as the right to obtain physician profiles. The declaration of rights shall contain the following statement:
'The patient has the right to file a grievance with the Composite State Board of Medical Examiners concerning the physician, staff, office, and treatment received. The patient should either call the board with such a complaint or send a written complaint to the board. The patient should be able to provide the physician or practice name, the address, and the specific nature of the complaint.'
Such notice shall include the current phone number and address of the board.
(c) The board must review every complaint received to determine if there is sufficient evidence to warrant an investigation according to a procedure established by board regulation. Only investigated complaints upon which the board has taken disciplinary action shall be included in a physician´s profile. The board must take the appropriate action as set forth in the regulations promulgated by the board. The board must respond in writing to the complaint within 60 days. In the response, the board shall inform the person whether the complaint is being referred for investigation, and if the complaint has been investigated, the results of the investigation or whether further investigation is required, and any board action taken.

43-34A-7.
(a) Any physician or authorized personnel violating any provision of this chapter shall be assessed a monetary fine as determined by the board by regulation for each day or instance of violation.
(b) A record of the violation shall be maintained as part of the physician profile.

43-34A-8.
(a) The board shall have profiles ready and be able to respond to request for profiles no later than July 1, 2002.
(b) All regulations required under this chapter shall be promulgated by the board by July 1, 2002."