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16  AN ACT concerning health care[; relating to health care] providers;
17    relating to peer review and risk management; [concerning cost re-
18    imbursement for certain food treatment products;] amending
19    K.S.A. 65-4925 and K.S.A. 1996 Supp. [65-180 and] 65-4915 and
20    repealing the existing sections.
21
22  Be it enacted by the Legislature of the State of Kansas:
23    Section 1.  K.S.A. 1996 Supp. 65-4915 is hereby amended to read as
24  follows: 65-4915. (a) As used in this section:
25    (1)  ``Health care provider'' means: (A) Those persons and entities
26  defined as a health care provider under K.S.A. 40-3401 and amendments
27  thereto; and (B) a dentist licensed by the Kansas dental board, a dental
28  hygienist licensed by the Kansas dental board, a professional nurse li-
29  censed by the board of nursing, a practical nurse licensed by the board
30  of nursing, a mental health technician licensed by the board of nursing,
31  a physical therapist assistant certified by the state board of healing arts,
32  an occupational therapist registered by the state board of healing arts, an
33  occupational therapy assistant registered by the state board of healing
34  arts, a respiratory therapist registered by the state board of healing arts,
35  a physician's assistant registered by the state board of healing arts and
36  attendants and ambulance services certified by the emergency medical
37  services board.
38    (2)  ``Health care provider group'' means:
39    (A)  A state or local association of health care providers or one or more
40  committees thereof;
41    (B)  the board of governors created under K.S.A. 40-3403 and amend-
42  ments thereto;
43    (C)  an organization of health care providers formed pursuant to state
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 1  or federal law and authorized to evaluate medical and health care services;
 2    (D)  a review committee operating pursuant to K.S.A. 65-2840b
 3  through 65-2840d, and amendments thereto;
 4    (E)  an organized medical staff of a licensed medical care facility as
 5  defined by K.S.A. 65-425 and amendments thereto, an organized medical
 6  staff of a private psychiatric hospital licensed under K.S.A. 75-3307b and
 7  amendments thereto or an organized medical staff of a state psychiatric
 8  hospital or state institution for the mentally retarded, as follows:  Larned
 9  state hospital, Osawatomie state hospital, Rainbow mental health facility,
10  Topeka state hospital, Kansas neurological institute, Norton state hospital,
11  Parsons state hospital and training center and Winfield state hospital and
12  training center;
13    (F)  a health care provider;
14    (G)  a professional society of health care providers or one or more
15  committees thereof;
16    (H)  a Kansas corporation whose stockholders or members are health
17  care providers or an association of health care providers, which corpora-
18  tion evaluates medical and health care services; or
19    (I)  an insurance company, health maintenance organization or ad-
20  ministrator of a health benefits plan which engages in any of the functions
21  defined as peer review under this section.
22    (3)  ``Peer review'' means any of the following functions:
23    (A)  Evaluate and improve the quality of health care services rendered
24  by health care providers;
25    (B)  determine that health services rendered were professionally in-
26  dicated or were performed in compliance with the applicable standard of
27  care;
28    (C)  determine that the cost of health care rendered was considered
29  reasonable by the providers of professional health services in this area;
30    (D)  evaluate the qualifications, competence and performance of the
31  providers of health care or to act upon matters relating to the discipline
32  of any individual provider of health care;
33    (E)  reduce morbidity or mortality;
34    (F)  establish and enforce guidelines designed to keep within reason-
35  able bounds the cost of health care;
36    (G)  conduct of research;
37    (H)  determine if a hospital's facilities are being properly utilized;
38    (I)  supervise, discipline, admit, determine privileges or control mem-
39  bers of a hospital's medical staff;
40    (J)  review the professional qualifications or activities of health care
41  providers;
42    (K)  evaluate the quantity, quality and timeliness of health care serv-
43  ices rendered to patients in the facility;
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 1    (L)  evaluate, review or improve methods, procedures or treatments
 2  being utilized by the medical care facility or by health care providers in
 3  a facility rendering health care.
 4    (4)  ``Peer review officer or committee'' means:
 5    (A)  An individual employed, designated or appointed by, or a com-
 6  mittee of or employed, designated or appointed by, a health care provider
 7  group and authorized to perform peer review; or
 8    (B)  a health care provider monitoring the delivery of health care at
 9  correctional institutions under the jurisdiction of the secretary of correc-
10  tions.
11    (b)  Except as provided by K.S.A. 60-437 and amendments thereto
12  and by subsections (c) and (d), the reports, statements, memoranda, pro-
13  ceedings, findings and other records of submitted to or generated by
14  peer review committees or officers shall be privileged and shall not be
15  subject to discovery, subpoena or other means of legal compulsion for
16  their release to any person or entity or be admissible in evidence in any
17  judicial or administrative proceeding. Information contained in such rec-
18  [chords shall not be discoverable or admissible at trial in the form of testi-
19  mony by an individual who participated in the peer review process. The
20  peer review officer or committee creating or initially receiving the record
21  is the holder of the privilege established by this section. This privilege may
22  be claimed by the legal entity creating the peer review committee or
23  officer, or by the commissioner of insurance for any records or proceed-
24  ings of the board of governors.
25    (c)  Subsection (b) shall not apply to proceedings in which a health
26  care provider contests the revocation, denial, restriction or termination
27  of staff privileges or the license, registration, certification or other au-
28  thorization to practice of the health care provider. A licensing agency
29  conducting a disciplinary proceeding in which admission of any report
30  or record under this section is proposed shall hold the hearing in closed
31  session when any such report or record is disclosed. A licensing agency
32  in conducting a disciplinary proceeding in which admission of any
33  report, record or testimony relating to any report or record under
34  this section is proposed shall hold the hearing in closed session
35  when any such report, record or testimony is disclosed. [Unless
36  otherwise provided by law, a licensing agency conducting a disci-
37  plinary proceeding may close only that portion of the hearing in
38  which disclosure of a report or record privileged under this section
39  is proposed. In closing a portion of a hearing as provided by this
40  section, the presiding officer may exclude any person from the hear-
41  ing location except the licensee, the licensee's attorney, the agency's
42  attorney, the witness, the court reporter and appropriate staff sup-
43  port for either counsel.] The licensing agency shall make all [the] por-
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 1  tions of the agency record in which such report or record is disclosed
 2  subject to a protective order prohibiting further disclosure of such report
 3  or record. Such report or record shall not be subject to discovery, sub-
 4  poena or other means of legal compulsion for their release to any person
 5  or entity. No person in attendance at any a closed session held as a
 6  part of a [portion of a] disciplinary proceeding shall be required to
 7  testify, nor shall the testimony of such person be admitted into evidence,
 8  in any other civil, criminal or administrative action, regarding the exis-
 9  tence or contents of a report or record under this section which is disclosed
10  in a disciplinary proceeding [at a subsequent civil, criminal or ad-
11  ministrative hearing, be required to testify regarding the existence
12  or content of a report or record privileged under this section which
13  was disclosed in a closed portion of a hearing, nor shall such testi-
14  mony be admitted into evidence in any subsequent civil, criminal
15  or administrative hearing. A licensing agency in conducting a dis-
16  ciplinary proceeding shall cause to be investigated independently
17  from any testimony, report or record under this section such mat-
18  ters as may be contained in such testimony, report or record and
19  shall cause to be presented such independently obtained informa-
20  tion as part of the disciplinary proceeding in open meeting of the
21  licensing agency]. A licensing agency conducting a disciplinary
22  proceeding may not rely solely on peer review committee records,
23  testimony or reports and must prove its findings with indepen-
24  dently obtained testimony or records which shall be presented as
25  part of the disciplinary proceeding in open meeting of the licens-
26  ing agency. Offering such testimony or records in an open public
27  hearing shall not be deemed a waiver of the peer review privilege
28  relating to any peer review committee testimony, records or re-
29  port.
30    (d)  Nothing in this section shall limit the authority, which may oth-
31  erwise be provided by law, of the commissioner of insurance, the state
32  board of healing arts or other health care provider licensing or disciplinary
33  boards of this state to require a peer review committee or officer to report
34  to it any disciplinary action or recommendation of such committee or
35  officer; to transfer to it records of such committee's or officer's proceed-
36  ings or actions to restrict or revoke the license, registration, certification
37  or other authorization to practice of a health care provider; or to terminate
38  the liability of the fund for all claims against a specific health care provider
39  for damages for death or personal injury pursuant to subsection (i) of
40  K.S.A. 40-3403 and amendments thereto.  Reports and records so fur-
41  nished shall not be subject to discovery, subpoena or other means of legal
42  compulsion for their release to any person or entity and shall not be
43  admissible in evidence in any judicial or administrative proceeding other
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 1  than a disciplinary proceeding by the state board of healing arts or other
 2  health care provider licensing or disciplinary boards of this state.
 3    (e)  A peer review committee or officer may report to and discuss its
 4  activities, information and findings to other peer review committees or
 5  officers or to a board of directors or an administrative officer of a health
 6  care provider without waiver of the privilege provided by subsection (b)
 7  and the records of all such committees or officers relating to such report
 8  shall be privileged as provided by subsection (b).
 9    (f)  Nothing in this section shall be construed to prevent an insured
10  from obtaining information pertaining to payment of benefits under a
11  contract with an insurance company, a health maintenance organization
12  or an administrator of a health benefits plan.
13    Sec. 2.  K.S.A. 65-4925 is hereby amended to read as follows: 65-
14  4925. (a) The reports and records made pursuant to K.S.A. 65-4923 or
15  65-4924, and amendments thereto, shall be confidential and privileged,
16  including:
17    (1)  Reports and records of executive or review committees of medical
18  care facilities or of a professional society or organization;
19    (2)  reports and records of the chief of the medical staff, chief admin-
20  istrative officer or risk manager of a medical care facility;
21    (3)  reports and records of any state licensing agency or impaired pro-
22  vider committee of a professional society or organization; and
23    (4)  reports made pursuant to this act to or by a medical care facility
24  risk manager, any committee, the board of directors, administrative of-
25  ficer or any consultant.
26    Such reports and records shall not be subject to discovery, subpoena
27  or other means of legal compulsion for their release to any person or
28  entity and shall not be admissible in any civil or administrative action
29  other than a disciplinary proceeding by the appropriate state licensing
30  agency.
31    (b)  No person in attendance at any meeting of an executive or review
32  committee of a medical care facility or of a professional society or organ-
33  ization while such committee is engaged in the duties imposed by K.S.A.
34  65-4923 shall be compelled to testify in any civil, criminal or administra-
35  tive action, other than a disciplinary proceeding by the appropriate li-
36  censing agency, as to any committee discussions or proceedings.
37    (c)  No person in attendance at any meeting of an impaired provider
38  committee shall be required to testify, nor shall the testimony of such
39  person be admitted into evidence, in any civil, criminal or administrative
40  action, other than a disciplinary proceeding by the appropriate state li-
41  censing agency, as to any committee discussions or proceedings.
42    (d)  Any person or committee performing any duty pursuant to this
43  act shall be designated a peer review committee or officer pursuant to
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 1  K.S.A. 65-4915 and amendments thereto.
 2    (e)  A licensing agency in conducting a disciplinary proceeding in
 3  which admission of any report or, record or testimony relating to any
 4  report or record under this section is proposed shall hold the hearing
 5  in closed session when any such report or, record or testimony is dis-
 6  closed. Unless otherwise provided by law, a licensing agency con-
 7  ducting a disciplinary proceeding may close only that portion of
 8  the hearing in which disclosure of a report or record privileged
 9  under this section is proposed. In closing a portion of a hearing as
10  provided by this section, the presiding officer may exclude any
11  person from the hearing location except the licensee, the licensee's
12  attorney, the agency's attorney, the witness, the court reporter and
13  appropriate staff support for either counsel. The licensing agency
14  shall make all the portions of the agency record in which such report or
15  record is disclosed subject to a protective order prohibiting further dis-
16  closure of such report or record. Such report or record shall not be
17  subject to discovery, subpoena or other means of legal compulsion
18  for their release to any person or entity. No person in attendance at
19  any a closed session held as a part portion of a disciplinary proceeding
20  shall be required to testify, nor shall the testimony of such person be
21  admitted into evidence, in any other civil, criminal or administrative ac-
22  tion, regarding the existence or contents of a report or record under this
23  section which is disclosed in a disciplinary proceeding. at a subsequent
24  civil, criminal or administrative hearing, be required to testify re-
25  garding the existence or content of a report or record privileged
26  under this section which was disclosed in a closed portion of a
27  hearing, nor shall such testimony be admitted into evidence in any
28  subsequent civil, criminal or administrative hearing. A licensing
29  agency conducting a disciplinary proceeding may not rely solely
30  on peer review committee records, testimony or reports and must
31  prove its findings with independently obtained testimony or rec-
32  [chords which shall be presented as part of the disciplinary proceed-
33  ing in open meeting of the licensing agency. Offering such testi-
34  mony or records in an open public hearing shall not be deemed a
35  waiver of the peer review privilege relating to any peer review
36  committee testimony, records or report.
37    [Sec. 3.  K.S.A. 1996 Supp. 65-180 is hereby amended to read
38  as follows: 65-180. The secretary of health and environment shall:
39    [(a)  Institute and carry on an intensive educational program
40  among physicians, hospitals, public health nurses and the public
41  concerning congenital hypothyroidism, galactosemia, phenylke-
42  tonuria and other genetic diseases detectable with the same spec-
43  imen. This educational program shall include information about
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 1  the nature of such conditions and examinations for the detection
 2  thereof in early infancy in order that measures may be taken to
 3  prevent the mental retardation or morbidity resulting from such
 4  conditions.
 5    [(b)  Provide recognized screening tests for phenylketonuria,
 6  galactosemia, hypothyroidism and such other diseases as may be
 7  appropriately detected with the same specimen. The initial labo-
 8  ratory screening tests for these diseases shall be performed by the
 9  department of health and environment for all infants born in the
10  state. Such services shall be performed without charge.
11    [(c)  Provide a follow-up program by providing test results and
12  other information to identified physicians; locate infants with ab-
13  normal newborn screening test results; with parental consent,
14  monitor infants to assure appropriate testing to either confirm or
15  not confirm the disease suggested by the screening test results;
16  with parental consent, monitor therapy and treatment for infants
17  with confirmed diagnosis of congenital hypothyroidism, galacto-
18  semia, phenylketonuria or other genetic diseases being screened
19  under this statute; and establish ongoing education and support
20  activities for individuals with confirmed diagnosis of congenital
21  hypothyroidism, galactosemia, phenylketonuria and other genetic
22  diseases being screened under this statute and for the families of
23  such individuals.
24    [(d)  Maintain a registry of cases including information of im-
25  portance for the purpose of follow-up services to prevent mental
26  retardation or morbidity.
27    [(e)  Provide the necessary treatment product for diagnosed
28  cases for as long as medically indicated, when the product is not
29  available through other state agencies. In addition to diagnosed cases
30  under this section, diagnosed cases of maple syrup urine disease shall be
31  included as a diagnosed case under this subsection.
32    [(f)  Except for treatment products provided under subsection (e), if
33  the medically necessary food treatment product for diagnosed cases must
34  be purchased, the purchaser shall be reimbursed by the department of
35  health and environment for costs incurred up to $1,500 per year per
36  diagnosed child age 18 or younger at 100% of the product cost upon
37  submission of a receipt of purchase identifying the company from which
38  the product was purchased. In addition to diagnosed cases under this
39  section, diagnosed cases of maple syrup urine disease shall be included as
40  a diagnosed case under this subsection. As an option to reimbursement
41  authorized under this subsection, the department of health and environ-
42  ment may purchase food treatment products for distribution to diagnosed
43  children in an amount not to exceed $1,500 per year per diagnosed child
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 1  age 18 or younger.]
 2    Sec. 3. [4.]  K.S.A. 65-4925 and K.S.A. 1996 Supp. [65-180 and] 65-
 3  4915 are hereby repealed.
 4    Sec. 4. [5.]  This act shall take effect and be in force from and after
 5  its publication in the Kansas register.