H. B. 4587
(By Delegates Foster, Palumbo and Amores)
[Introduced
February 23, 2004
; referred to the
Committee on Health and Human Resources then the Judiciary.]
A BILL to amend and reenact §30-3C-1 of the code of West Virginia,
1931, as amended, relating to including persons who are
members or consultants to review organizations within the
definition of health care professionals for peer review
purposes; including patient safety review in peer review; and
including certain other organizations within the meaning of a
review organization.
Be it enacted by the Legislature of West Virginia:
That §30-3C-1 of the code of West Virginia, 1931, as amended,
be amended and reenacted to read as follows:
ARTICLE 3C. HEALTH CARE PEER REVIEW ORGANIZATION PROTECTION.
§30-3C-1. Definitions.
As used in this article:
"Health care professionals" means mean individuals who are
licensed to practice in any health care field under the laws of this state and individuals, who, because of their education,
experience or training participate as members of or consultants to
a review organization.
"Peer review" means the procedure for evaluation by health
care professionals of the quality and efficiency of services
ordered or performed by other health care professionals, including
practice analysis, inpatient hospital and extended care facility
utilization review, medical audit, ambulatory care review, and
claims review and patient safety review;
"Professional society" includes medical, psychological,
nursing, dental, optometric, pharmaceutical, chiropractic and
podiatric organizations having as members at least a majority of
the eligible licentiates in the area or health care facility or
agency served by the particular organization; and
"Review organization" means any committee or organization
engaging in peer review, including a hospital utilization review
committee, a hospital tissue committee, a medical audit committee,
a health insurance review committee, a health maintenance
organization review committee, hospital, medical, dental and health
service corporation review committee, a hospital plan corporation
review committee, a professional health service plan review
committee or organization, a dental review committee, a physicians'
advisory committee, a podiatry advisory committee, a nursing
advisory committee, any committee or organization established pursuant to a medical assistance program, an entity established
pursuant to the joint commission on accreditation of health care
organizations or state or federal law or similar accrediting body
and any committee established by one or more state or local
professional societies or institutes, to gather and review
information relating to the care and treatment of patients for the
purposes of: (i) Evaluating and improving the quality of health
care rendered; (ii) reducing morbidity or mortality; or (iii)
establishing and enforcing guidelines designed to keep within
reasonable bounds the cost of health care. It shall also mean any
hospital board committee or organization reviewing the professional
qualifications or activities of its medical staff or applicants for
admission thereto, and any professional standards review
organizations established or required under state or federal
statutes or regulations.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.