[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5122 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 5122

To amend the Health Care Quality Improvement Act of 1986 to provide for 
the availability to the public of information reported to the National 
    Practitioner Data Bank under such Act, to establish additional 
            reporting requirements, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 7, 2000

  Mr. Bliley introduced the following bill; which was referred to the 
                         Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
To amend the Health Care Quality Improvement Act of 1986 to provide for 
the availability to the public of information reported to the National 
    Practitioner Data Bank under such Act, to establish additional 
            reporting requirements, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Patient Protection Act of 2000''.

   TITLE I--PUBLIC AVAILABILITY OF PHYSICIAN INFORMATION IN NATIONAL 
                         PRACTITIONER DATA BANK

SEC. 101. PUBLIC AVAILABILITY OF PHYSICIAN INFORMATION.

    (a) In General.--Part B of the Health Care Quality Improvement Act 
of 1986 (42 U.S.C. 11131 et seq.) is amended by inserting after section 
427 the following section:

``SEC. 428. PUBLIC AVAILABILITY OF PHYSICIAN INFORMATION.

    ``(a) In General.--Not later than January 31, 2001, the Secretary, 
notwithstanding any other provision of this part, shall in accordance 
with this section promulgate regulations under which the public may, 
through the method described in subsection (c), obtain information 
reported under this part on physicians.
    ``(b) Limitations.--The following information on a physician may 
not under subsection (a) be made available to the public:
            ``(1) Information disclosing the identity of any patient 
        involved in the incidents involved.
            ``(2) The home address of the physician.
            ``(3) The social security account number of the physician.
            ``(4) The date of birth of the physician.
            ``(5) The number assigned to the physician by the Drug 
        Enforcement Administration.
            ``(6) The name, title, and telephone number of the official 
        with responsibility for submitting the report on behalf of the 
        entity.
    ``(c) Use of Internet.--For purposes of subsection (a), the method 
described in this subsection is to make the information involved 
available to the public, without charge, through the telecommunications 
medium known as the World Wide Web of the Internet. The Secretary, 
acting through the Administrator of the Health Resources and Services 
Administration, shall provide for the establishment of a site on such 
medium, and shall update the information maintained through such medium 
not less frequently than monthly.
    ``(d) Statement of Physician.--Regulations under subsection (a) 
shall require that each disclosure under such subsection include any 
statement that was submitted under section 426(b) by the physician 
involved.
    ``(e) Context of Disclosed Information on Medical Malpractice 
Payments.--With respect to information reported under section 421 on a 
physician, regulations under subsection (a) shall require that a 
disclosure of a report under such section be accompanied by 
supplemental information in accordance with the following:
            ``(1) For each State for which such a report is made on the 
        physician:
                    ``(A) The information under section 421 shall be 
                presented in context by comparing the physician 
                involved to the experiences of other physicians in the 
                same specialty in the same State.
                    ``(B) In disclosing the amount of the payment 
                reported under section 421(b)(2):
                            ``(i) The amount shall be presented in 
                        context by categorizing the amount in a manner 
                        that indicates the level of significance of the 
                        payment in relation to amounts reported under 
                        such section for other physicians in the same 
                        specialty in the same State. For such purposes, 
                        there shall be a minimum of three graduated 
                        categories.
                            ``(ii) The disclosure shall state whether 
                        the amount was made in settlement (or partial 
                        settlement) of, or in satisfaction of a 
                        judgment in, a medical malpractice action or 
                        claim.)
            ``(2) A statement providing that a payment made pursuant to 
        a medical malpractice action or claim may occur for a variety 
        of reasons which do not necessarily reflect negatively on the 
        professional competence or conduct of the physician.
            ``(3) A statement providing that a payment made pursuant to 
        a medical malpractice action or claim should not be construed 
        as creating a presumption that medical malpractice has 
        occurred.
            ``(4) A statement providing that some physicians work 
        primarily with high risk patients, and such physicians may have 
        numbers of medical malpractice actions or claims that are 
        higher than average for their specialties because they 
        specialize in cases or patients who are at very high risk for 
        medical problems.
            ``(5) A statement providing that--
                    ``(A) malpractice histories tend to vary by 
                specialty, and some specialties are more likely than 
                others to be the subject of litigation, and
                    ``(B) the disclosure and accompanying information 
                compare physicians only to the members of their 
                specialty, not to all physicians, in order to make an 
                individual physician's history more meaningful.
            ``(6) A statement providing that--
                    ``(A) malpractice histories tend to vary by State, 
                and due to variations in State laws, physicians in some 
                States are more likely than those in other States to be 
                the subject of litigation, and
                    ``(B) the disclosure and accompanying information 
                compare physicians only to other physicians within a 
                given State, not to all physicians, in order to make an 
                individual physician's history more meaningful.
    ``(f) Context of Disclosed Information Regarding Criminal Acts.--
With respect to information that under section 422(c) or 424A is 
reported on a physician, regulations under subsection (a) shall require 
that a disclosure of a report under such a section be accompanied by a 
statement providing that the disclosure may fail to provide all crime-
related information on the physician because the availability of such 
information depends in part on State laws and in part on self-reporting 
by physicians.''.
    (b) Disclosure.--Section 427(b)(1) of the Health Care Quality 
Improvement Act of 1986 (42 U.S.C. 11137(b)(1)) is amended by striking 
``Information reported'' and inserting ``Except for the disclosure of 
information authorized by this title, information reported''.
    (c) Fees.--Section 427(b) of the Health Care Quality Improvement 
Act of 1986 (42 U.S.C. 11137(b)) is amended by striking paragraph (4).

 TITLE II--REPORTING REQUIREMENTS REGARDING NATIONAL PRACTITIONER DATA 
                                  BANK

SEC. 201. REQUIRING REPORTS ON MEDICAL MALPRACTICE PAYMENTS.

    Section 421(b) of the Health Care Quality Improvement Act of 1986 
(42 U.S.C. 11131(b)) is amended--
            (1) by redesignating paragraph (5) as paragraph (6);
            (2) in paragraph (4), by striking ``and'' after the comma 
        at the end; and
            (3) by inserting after paragraph (4) the following 
        paragraph:
            ``(5) in the case of a physician--
                    ``(A) the medical field of the physician, including 
                the medical specialty,
                    ``(B) the date on which the physician was first 
                licensed in the medical field and specialty, and the 
                number of years the physician has been practicing in 
                such field and specialty, and
                    ``(C) the professional license number of the 
                physician, and the name of the State in which the 
                license is held, and''.

SEC. 202. REPORTING OF SANCTIONS TAKEN BY BOARDS OF MEDICAL EXAMINERS.

    (a) In General.--Section 422(a) of the Health Care Quality 
Improvement Act of 1986 (42 U.S.C. 11132(a)) is amended--
            (1) in paragraph (1)(A), by striking ``which revokes or 
        suspends'' and inserting ``which denies, revokes, or 
        suspends''; and
            (2) in paragraph (2)--
                    (A) in subparagraph (B), by striking ``(if known)'' 
                and all that follows and inserting ``for the action 
                described in paragraph (1)(A) that was taken with 
                respect to the physician or, if known, for the 
                surrender of the license,'';
                    (B) by redesignating subparagraph (C) as 
                subparagraph (F);
                    (C) by inserting after subparagraph (B) the 
                following subparagraphs:
                    ``(C) the medical field of the physician, including 
                the medical specialty,
                    ``(D) the date on which the physician was first 
                licensed in the medical field and specialty, and the 
                number of years the physician has been practicing in 
                such field and specialty, and
                    ``(E) the professional license number of the 
                physician, and the name of the State in which the 
                license is held, and''.
    (b) Criminal Acts of Physicians.--Section 422 of the Health Care 
Quality Improvement Act of 1986 (42 U.S.C. 11132) is amended by adding 
at the end the following subsection:
    ``(c) Criminal Acts of Physicians.--
            ``(1) In general.--Each Board of Medical Examiners shall 
        report, in accordance with section 424, the information 
        described in paragraph (2), to the extent that the information 
        is collected by such Board.
            ``(2) Information to be reported.--With respect to the 
        Board of Medical Examiners of a State, the information to be 
        reported under paragraph (1) is as follows:
                    ``(A) A description of felony convictions of 
                physicians in courts of the State or other States.
                    ``(B) A description of such misdemeanor convictions 
                of physicians in such courts as in the Secretary's 
                discretion may reflect on quality health matters.
                    ``(C) A description of any criminal charges in such 
                courts to which the physician pled nolo contendere.''.
    (c) Contextual Information Regarding Disclosures of Physician 
Information.--Section 422 of the Health Care Quality Improvement Act of 
1986, as amended by subsection (b) of this section, is amended by 
adding at the end the following subsection:
    ``(d) Contextual Information Regarding Disclosures of Physician 
Information.--Each Board of Medical Examiners shall, in accordance with 
section 424, report to the Secretary such information as the Secretary 
may request from the Board for purposes of assisting the Secretary in 
making disclosures in accordance with section 428(e), to the extent 
that such information is collected by such Board.''.
    (d) Conforming Amendment.--Subsections (a) and (b) of section 424 
of the Health Care Quality Improvement Act of 1986 (42 U.S.C. 11134) 
are each amended by striking ``section 422(a)'' and inserting ``section 
422''.

SEC. 203. REPORTING OF CERTAIN PROFESSIONAL REVIEW ACTIONS TAKEN BY 
              HEALTH CARE ENTITIES.

    (a) In General.--Section 423(a)(3) of the Health Care Quality 
Improvement Act of 1986 (42 U.S.C. 11133(a)(3)) is amended--
            (1) in subparagraph (B), by striking ``and'' after 
        ``surrender,'';
            (2) by redesignating subparagraph (C) as subparagraph (D); 
        and
            (3) by inserting after subparagraph (B) the following 
        subparagraph:
                    ``(C) in the case of a physician--
                            ``(i) the medical field of the physician, 
                        including the medical specialty,
                            ``(ii) the date on which the physician was 
                        first licensed in the medical field and 
                        specialty, and the number of years the 
                        physician has been practicing in such field and 
                        specialty, and
                            ``(iii) the professional license number of 
                        the physician, and the name of the State in 
                        which the license is held, and''.
    (b) Applicability of Requirements to Federal Entities.--
            (1) In general.--Section 423 of the Health Care Quality 
        Improvement Act of 1986 (42 U.S.C. 11133) is amended by adding 
        at the end the following subsection:
    ``(e) Applicability to Federal Facilities and Physicians.--
            ``(1) In general.--Subsection (a) applies to Federal health 
        facilities (including hospitals) and actions by such facilities 
        regarding the competence or professional conduct of Federal 
        physicians to the same extent and in the same manner as such 
        subsection applies to health care entities and professional 
        review actions.
            ``(2) Relevant board of medical examiners.--For purposes of 
        paragraph (1), the Board of Medical Examiners to which a 
        Federal health facility is to report is the Board of Medical 
        Examiners of the State within which the facility is located.''.
            (2) Conforming amendment.--Section 432 of the Health Care 
        Quality Improvement Act of 1986 (42 U.S.C. 11152) is amended--
                    (A) by striking subsection (b); and
                    (B) by redesignating subsection (c) as subsection 
                (b).

SEC. 204. PHYSICIAN SELF-REPORTING REGARDING FELONY CONVICTIONS.

    Part B of the Health Care Quality Improvement Act of 1986 (42 
U.S.C. 11131 et seq.) is amended by inserting after section 424 the 
following section:

``SEC. 424A. PHYSICIAN SELF-REPORTING REGARDING FELONY CONVICTIONS.

    ``(a) In General.--Each physician shall report, in accordance with 
subsection (b), each felony conviction of the physician.
    ``(b) Form of Reporting.--The information required to be reported 
under subsection (a) shall--
            ``(1) be reported regularly (but not less often than 
        monthly) and in such form and manner as the Secretary 
        prescribes, and
            ``(2) be reported to the Secretary, or, in the Secretary's 
        discretion, to the agency described in section 424(b).
    ``(c) Sanctions for Failure To Report.--Any physician who fails to 
report information on a felony conviction required to be reported under 
this section shall be subject to a civil money penalty of not more than 
$10,000 for each such failure to report. Such penalty shall be imposed 
and collected in the same manner as civil money penalties under 
subsection (a) of section 1128A of the Social Security Act are imposed 
and collected under that section.''.

SEC. 205. NOTICE TO PRACTITIONERS; CORRECTION OF INFORMATION.

    Section 426 of the Health Care Quality Improvement Act of 1986 (42 
U.S.C. 11136) is amended--
            (1) by inserting ``(a) In General.--'' before ``With 
        respect to'';
            (2) in subsection (a) (as so designated), in paragraph (1), 
        by striking ``, upon request,''; and
            (3) by adding at the end the following subsection:
    ``(b) Statement of Practitioner.--
            ``(1) In general.--With respect to information reported 
        under this part, if the physician or other licensed health care 
        practitioner involved submits to the Secretary a statement 
        regarding the information so reported, the statement shall be 
        made a part of the report involved, subject to paragraph (2). 
        Such a statement may be made at any time, and may be revised.
            ``(2) Length of statement.--Paragraph (1) applies to a 
        statement by a physician or other licensed health care 
        practitioner only if the statement does not exceed 4,000 
        characters, including spaces and punctuation.
            ``(3) Notice.--In carrying out subsection (a)(1), the 
        Secretary shall inform the practitioner involved that a 
        statement under paragraph (1) may be submitted, and that the 
        statement is subject to the limitation described in paragraph 
        (2).''.

                 TITLE III--DUTY TO OBTAIN INFORMATION

SEC. 301. DUTY OF HOSPITALS TO OBTAIN INFORMATION.

    Section 425 of the Health Care Quality Improvement Act of 1986 (42 
U.S.C. 11135) is amended by adding at the end the following subsection:
    ``(d) Applicability to Federal Hospitals.--This section applies to 
Federal hospitals to the same extent and in the same manner as such 
subsection applies to other hospitals.''.

SEC. 302. DUTY OF BOARDS OF MEDICAL EXAMINERS TO OBTAIN INFORMATION.

    Part B of the Health Care Quality Improvement Act of 1986 (42 
U.S.C. 11131 et seq.) is amended by inserting after section 425 the 
following section:

``SEC. 425A. DUTY OF BOARDS OF MEDICAL EXAMINERS TO OBTAIN INFORMATION.

    ``(a) In General.--Effective six months after the date of the 
enactment of the Patient Protection Act of 2000, it is the duty of each 
Board of Medical Examiners to request from the Secretary (or the agency 
designated under section 424(b)) information reported under this part 
concerning a physician--
            ``(1) at the time the physician submits the initial 
        application for a physician's license in the State involved, 
        and
            ``(2) at each time the physician submits an application to 
        continue in effect the license.
A Board of Medical Examiners may request information reported under 
this part concerning a physician at other times.
    ``(b) Failure To Obtain Information.--With respect to an action for 
mandamus or other cause of action against a Board of Medical Examiners, 
a Board which does not request information respecting a physician as 
required under subsection (a) is presumed to have knowledge of any 
information reported under this part to the Secretary with respect to 
the physician.
    ``(c) Reliance on Information Provided.--With respect to a cause of 
action against a Board of Medical Examiners, each Board of Medical 
Examiners may rely upon information provided to the Board under this 
title, unless the Board has knowledge that the information provided was 
false.''.

                      TITLE IV--GENERAL PROVISIONS

SEC. 401. REQUEST OF BOARD OF MEDICAL EXAMINERS REGARDING PHYSICIAN 
              INFORMATION IN NATIONAL PRACTITIONER DATA BANK.

    Section 427(a) of the Health Care Quality Improvement Act of 1986 
(42 U.S.C. 11137(a)) is amended by adding at the end the following: 
``The Secretary (or the agency designated under section 424(b)) shall, 
upon request, provide the Board of Medical Examiners of a State a 
summary of information reported under this part on physicians who are 
licensed in that State. For each physician included in such a summary, 
the summary shall at a minimum provide the name, address, total number 
of reports of such information, and the number of reports for each 
report type.''.

SEC. 402. REGULATIONS; EFFECTIVE DATE.

    The Secretary of Health and Human Services shall promulgate a final 
rule to implement the amendments made by this Act not later than 
January 31, 2001. Such amendments take effect 30 days after the date on 
which such final rule is promulgated.
                                 <all>