Office of Sen.

Mike Johnston
Colorado General Assembly | 200 E. Colfax Avenue | Denver, CO 80203 | 303.866.4864

FACT SHEET MEMORANDUM

HB 12-1300 Concerning Professional Review Committees Rep. Gardner & Sen. Aguilar Staff Name: Gaby Corica What the Bill Does: Currently, the Colorado Medical Board acts on behalf of the state to govern licensure, discipline and professional review of anyone licensed to practice medicine in the state.1 This only includes people with a medical license, like physicians. Presently, the functions of professional review committees expire in July, 2013. HB 12-1300 continues these functions for seven more years, until 2019. HB 12-1300 also aims to give the State Board of Nursing the same sovereign capacity the Colorado Medical Board has when it comes to governing licensure, discipline, and professional review. These two boards would not only be reviewing people licensed to practice medicine but also people who are licensed as physician assistants, as nurses, and as advanced practice nurses. This creates more regulatory boards for healthcare providers. Currently, a member of a professional review committee, a witness before a professional review committee, or any person who files a complaint or otherwise participates in the professional review process is immune from suit in any civil or criminal action, including antitrust actions, brought by a physician who is the subject of the review by such professional review committee.2 Because the bill expands the professional reviewing power within the healthcare industry, the bill also requires that entities that conduct professional review of physicians or physician assistants register with the Colorado Medical Board and report their activities to that board. Similarly, entities that conduct review of advanced practice burses must register with the State Nursing Board. The bill also stipulates that if an entity fails to register and report as it is required, that entity and its governing board lose the qualified immunity that would otherwise apply for acts and omissions occurring during the period of noncompliance. Colorado Context: Although any organization can technically conduct professional reviews, only those covered by the Colorado Professional Review Act (CPRA) can claim legal privilege and immunity for these types of activities.3 Professional review is typically conducted by organized medical staffs of hospitals and
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See C.R.S. 12-36.5-101(1) C.R.S. 12-36.5-105(1) 3 Clare Pramuk, Fiscal Note HB 12-1300, Feb. 27, 2012. http://www.leg.state.co.us/clics/clics2012a/csl.nsf/fsbillcont3/77C59F0080D4319587257981007F1180?Open&file =HB1300_00.pdf.

DRAFT 3/27/2012 9:22 PM3/24/2012 9:04 AM

For a complete list of fact sheets, visit www.mikejohnston.org/in-the-legislature.

ambulatory surgical centers and guided by medical staff bylaws.4 A review can be triggered by a complaint, poor outcome, or identification of a problematic trend in the practice of a physician.5 If a professional review results in a finding that the physician failed to meet the standard of care, the case is referred to the facilitys governing board for a hearing and possible action.6 The governing board typically includes members of the medical staff, hospital administrators and others and the physician has legal recourse for appealing the decision of the governing board.7 National Context: California has Medical Review Boards in place for physicians, surgeons, licensed midwives and medical assistants and other, but does not seem to have professional review board alliance with its nurses.8 Meanwhile, New Yorks Office of Professional Medical Conduct investigates complaints about physicians, physician assistants and specialist assistants and monitors practitioners who are subject to Orders of this state board.9 Bill Provisions: This bill includes the following provisions: o Authorizes professional review of physician assistants and advanced practice nurses; o Enables sharing of professional review records and information with regulators and other professional review entities; o Requires governing bodies that conduct professional reviews to register with their respective boards and report on their activities. Fiscal Impact: The Colorado Legislative Council estimates that this bill requires an increase of $9,175 in FY 2012-13 only for the Division of Registration in the Department of Regulatory Affairs from the Division of Registrations cash fund. This increase will be funded by fees paid by more than 30,000 healthcare professionals. The fee per healthcare professional is expected to be less than $ .50 each. The Division of Registrations will update its computer system to accommodate the registration of new governing boards. The Division will use temporary staff to assist in the registration process at a cost of $6,222.

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Id. Id. 6 Id. 7 Id. 8 The Medical Board of California (last visited Mar. 22, 2012) http://www.mbc.ca.gov/ allied/Index.html. 9 New York State Department of Health (last visited Mar. 22, 2012) http://www.health .ny.gov/professionals/doctors/conduct/.

DRAFT 3/27/2012 9:22 PM3/24/2012 9:04 AM

For a complete list of fact sheets, visit www.mikejohnston.org/in-the-legislature.