As Reported by the House Health and Aging Committee

130th General Assembly
Regular Session
2013-2014
Sub. H. B. No. 123


Representatives Gonzales, Wachtmann 

Cosponsors: Representatives Adams, J., Brenner, Henne, McClain, Williams, Young, Bishoff, Brown, Schuring 

A BILL
To amend sections 2305.25 and 2305.252 and to enact 1
section 5111.0216 of the Revised Code regarding 2
health care peer review committee proceedings and 3
Medicaid coverage of telehealth services.4


BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

       Section 1. That sections 2305.25 and 2305.252 be amended and 5
section 5111.0216 of the Revised Code be enacted to read as 6
follows:7

       Sec. 2305.25. As used in this section and sections 2305.251 8
to 2305.253 of the Revised Code:9

       (A)(1) "Health care entity" means an entity, whether acting 10
on its own behalf or on behalf of or in affiliation with other 11
health care entities, that conducts as part of its regular 12
business activities professional credentialing or quality review 13
activities involving the competence of, professional conduct of, 14
or quality of care provided by health care providers, including 15
both individuals who provide health care and entities that provide 16
health care.17

       (2) "Health care entity" includes any entity described in 18
division (A)(1) of this section, regardless of whether it is a 19
government entity; for-profit or nonprofit corporation; limited 20
liability company; partnership; professional corporation; state or 21
local society composed of physicians, dentists, optometrists, 22
psychologists, or pharmacists; oraccountable care organization;23
other health care organization; or combination of any of the 24
foregoing entities.25

       (B) "Health insuring corporation" means an entity that holds 26
a certificate of authority under Chapter 1751. of the Revised 27
Code. "Health insuring corporation" includes wholly owned 28
subsidiaries of a health insuring corporation.29

       (C) "Hospital" means eitherany of the following:30

       (1) An institution that has been registered or licensed by 31
the department of health as a hospital;32

       (2) An entity, other than an insurance company authorized to 33
do business in this state, that owns, controls, or is affiliated 34
with an institution that has been registered or licensed by the 35
department of health as a hospital;36

       (3) A group of hospitals that are owned, sponsored, or 37
managed by a single entity.38

       (D) "Incident report or risk management report" means a 39
report of an incident involving injury or potential injury to a 40
patient as a result of patient care provided by health care 41
providers, including both individuals who provide health care and 42
entities that provide health care, that is prepared by or for the 43
use of a peer review committee of a health care entity and is 44
within the scope of the functions of that committee.45

       (E)(1) "Peer review committee" means a utilization review 46
committee, quality assessment committee, performance improvement 47
committee, tissue committee, credentialing committee, or other 48
committee that does either of the following:49

       (a) Conducts professional credentialing or quality review 50
activities involving the competence of, professional conduct of, 51
or quality of care provided by health care providers, including 52
both individuals who provide health care and entities that provide 53
health care;54

       (b) Conducts any other attendant hearing process initiated as 55
a result of a peer review committee's recommendations or actions.56

       (2) "Peer review committee" includes all of the following:57

       (a) A peer review committee of a hospital or long-term care 58
facility or a peer review committee of a nonprofit health care 59
corporation that is a member of the hospital or long-term care 60
facility or of which the hospital or facility is a member;61

       (b) A peer review committee of a community mental health 62
center;63

       (c) A board or committee of a hospital, a long-term care 64
facility, or other health care entity when reviewing professional 65
qualifications or activities of health care providers, including 66
both individuals who provide health care and entities that provide 67
health care;68

       (d) A peer review committee, professional standards review 69
committee, or arbitration committee of a state or local society 70
composed of members who are in active practice as physicians, 71
dentists, optometrists, psychologists, or pharmacists;72

       (e) A peer review committee of a health insuring corporation 73
that has at least a two-thirds majority of member physicians in 74
active practice and that conducts professional credentialing and 75
quality review activities involving the competence or professional 76
conduct of health care providers that adversely affects or could 77
adversely affect the health or welfare of any patient;78

       (f) A peer review committee of a health insuring corporation 79
that has at least a two-thirds majority of member physicians in 80
active practice and that conducts professional credentialing and 81
quality review activities involving the competence or professional 82
conduct of a health care facility that has contracted with the 83
health insuring corporation to provide health care services to 84
enrollees, which conduct adversely affects, or could adversely 85
affect, the health or welfare of any patient;86

       (g) A peer review committee of a sickness and accident 87
insurer that has at least a two-thirds majority of physicians in 88
active practice and that conducts professional credentialing and 89
quality review activities involving the competence or professional 90
conduct of health care providers that adversely affects or could 91
adversely affect the health or welfare of any patient;92

       (h) A peer review committee of a sickness and accident 93
insurer that has at least a two-thirds majority of physicians in 94
active practice and that conducts professional credentialing and 95
quality review activities involving the competence or professional 96
conduct of a health care facility that has contracted with the 97
insurer to provide health care services to insureds, which conduct 98
adversely affects, or could adversely affect, the health or 99
welfare of any patient;100

       (i) A peer review committee of any insurer authorized under 101
Title XXXIX of the Revised Code to do the business of medical 102
professional liability insurance in this state that conducts 103
professional quality review activities involving the competence or 104
professional conduct of health care providers that adversely 105
affects or could affect the health or welfare of any patient;106

       (j) A peer review committee of the bureau of workers' 107
compensation or the industrial commission that is responsible for 108
reviewing the professional qualifications and the performance of 109
providers conducting medical examinations or file reviews for the 110
bureau or the commission;111

       (k) Any other peer review committee of a health care entity.112

       (F) "Physician" means an individual authorized to practice 113
medicine and surgery, osteopathic medicine and surgery, or 114
podiatric medicine and surgery.115

       (G) "Sickness and accident insurer" means an entity 116
authorized under Title XXXIX of the Revised Code to do the 117
business of sickness and accident insurance in this state.118

       (H) "Tort action" means a civil action for damages for 119
injury, death, or loss to a patient of a health care entity. "Tort 120
action" includes a product liability claim, as defined in section 121
2307.71 of the Revised Code, and an asbestos claim, as defined in 122
section 2307.91 of the Revised Code, but does not include a civil 123
action for a breach of contract or another agreement between 124
persons.125

       (I) "Accountable care organization" means such an 126
organization as defined in 42 C.F.R. 425.20.127

       Sec. 2305.252.  Proceedings and records within the scope of a 128
peer review committee of a health care entity shall be held in 129
confidence and shall not be subject to discovery or introduction 130
in evidence in any civil action against a health care entity or 131
health care provider, including both individuals who provide 132
health care and entities that provide health care, arising out of 133
matters that are the subject of evaluation and review by the peer 134
review committee. No individual who attends a meeting of a peer 135
review committee, serves as a member of a peer review committee, 136
works for or on behalf of a peer review committee, or provides 137
information to a peer review committee shall be permitted or 138
required to testify in any civil action as to any evidence or 139
other matters produced or presented during the proceedings of the 140
peer review committee or as to any finding, recommendation, 141
evaluation, opinion, or other action of the committee or a member 142
thereof. Information143

       Information, documents, or records otherwise available from 144
original sources are not to be construed as being unavailable for 145
discovery or for use in any civil action merely because they were 146
produced or presented during proceedings of a peer review 147
committee, but the information, documents, or records are 148
available only from the original sources and cannot be obtained 149
from the peer review committee's proceedings or records. An150
Release of any information, documents, or records that were 151
produced or presented during proceedings of a peer review 152
committee or created to document the proceedings does not affect 153
the confidentiality of any other information, documents, or 154
records produced or presented during those proceedings or created 155
to document them. Only the information, documents, or records 156
actually released cease to be privileged under this section.157

        Nothing in this section precludes health care entities from 158
sharing information, documents, or records that were produced or 159
presented during proceedings of a peer review committee or created 160
to document them as long as the information, documents, or records 161
are used only for peer review purposes.162

        An individual who testifies before a peer review committee, 163
serves as a representative of a peer review committee, serves as a 164
member of a peer review committee, works for or on behalf of a 165
peer review committee, or provides information to a peer review 166
committee shall not be prevented from testifying as to matters 167
within the individual's knowledge, but the individual cannot be 168
asked about the individual's testimony before the peer review 169
committee, information the individual provided to the peer review 170
committee, or any opinion the individual formed as a result of the 171
peer review committee's activities. An172

       An order by a court to produce for discovery or for use at 173
trial the proceedings or records described in this section is a 174
final order.175

       Sec. 5111.0216.  (A) As used in this section, "telehealth 176
service" means a health care service delivered to a patient 177
through the use of interactive audio, video, or other 178
telecommunications or electronic technology from a site other than 179
the site where the patient is located.180

       (B) The office of medical assistance shall establish 181
standards for medicaid reimbursement for health care services the 182
office determines are appropriate to be covered by the medicaid 183
program when provided as telehealth services. The standards shall 184
be established in rules adopted under section 5111.02 of the 185
Revised Code.186

       Section 2. That existing sections 2305.25 and 2305.252 of the 187
Revised Code are hereby repealed.188