As Reported by the Senate Medicaid, Health and Human Services Committee

Corrected Version

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


Representatives Gonzales, Wachtmann 

Cosponsors: Representatives Adams, J., Brenner, Henne, McClain, Williams, Young, Bishoff, Brown, Schuring, Anielski, Antonio, Baker, Boose, Buchy, Budish, Burkley, Duffey, Hackett, Hill, Johnson, Letson, Phillips, Romanchuk, Sears, Sprague Speaker Batchelder 

Senator Tavares 

A BILL
To amend sections 2305.25 and 2305.252 and to enact 1
section 5164.94 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 5164.94 of the Revised Code be enacted to read as follows:6

       Sec. 2305.25. As used in this section and sections 2305.251 7
to 2305.253 of the Revised Code:8

       (A)(1) "Health care entity" means an entity, whether acting 9
on its own behalf or on behalf of or in affiliation with other 10
health care entities, that conducts as part of its regular 11
business activities professional credentialing or quality review 12
activities involving the competence of, professional conduct of, 13
or quality of care provided by health care providers, including 14
both individuals who provide health care and entities that provide 15
health care.16

       (2) "Health care entity" includes any entity described in 17
division (A)(1) of this section, regardless of whether it is a 18
government entity; for-profit or nonprofit corporation; limited 19
liability company; partnership; professional corporation; state or 20
local society composed of physicians, dentists, optometrists, 21
psychologists, or pharmacists; oraccountable care organization;22
other health care organization; or combination of any of the 23
foregoing entities.24

       (B) "Health insuring corporation" means an entity that holds 25
a certificate of authority under Chapter 1751. of the Revised 26
Code. "Health insuring corporation" includes wholly owned 27
subsidiaries of a health insuring corporation.28

       (C) "Hospital" means eitherany of the following:29

       (1) An institution that has been registered or licensed by 30
the department of health as a hospital;31

       (2) An entity, other than an insurance company authorized to 32
do business in this state, that owns, controls, or is affiliated 33
with an institution that has been registered or licensed by the 34
department of health as a hospital;35

       (3) A group of hospitals that are owned, sponsored, or 36
managed by a single entity.37

       (D) "Incident report or risk management report" means a 38
report of an incident involving injury or potential injury to a 39
patient as a result of patient care provided by health care 40
providers, including both individuals who provide health care and 41
entities that provide health care, that is prepared by or for the 42
use of a peer review committee of a health care entity and is 43
within the scope of the functions of that committee.44

       (E)(1) "Peer review committee" means a utilization review 45
committee, quality assessment committee, performance improvement 46
committee, tissue committee, credentialing committee, or other 47
committee that does either of the following:48

       (a) Conducts professional credentialing or quality review 49
activities involving the competence of, professional conduct of, 50
or quality of care provided by health care providers, including 51
both individuals who provide health care and entities that provide 52
health care;53

       (b) Conducts any other attendant hearing process initiated as 54
a result of a peer review committee's recommendations or actions.55

       (2) "Peer review committee" includes all of the following:56

       (a) A peer review committee of a hospital or long-term care 57
facility or a peer review committee of a nonprofit health care 58
corporation that is a member of the hospital or long-term care 59
facility or of which the hospital or facility is a member;60

       (b) A peer review committee of a community mental health 61
center;62

       (c) A board or committee of a hospital, a long-term care 63
facility, or other health care entity when reviewing professional 64
qualifications or activities of health care providers, including 65
both individuals who provide health care and entities that provide 66
health care;67

       (d) A peer review committee, professional standards review 68
committee, or arbitration committee of a state or local society 69
composed of members who are in active practice as physicians, 70
dentists, optometrists, psychologists, or pharmacists;71

       (e) A peer review committee of a health insuring corporation 72
that has at least a two-thirds majority of member physicians in 73
active practice and that conducts professional credentialing and 74
quality review activities involving the competence or professional 75
conduct of health care providers that adversely affects or could 76
adversely affect the health or welfare of any patient;77

       (f) A peer review committee of a health insuring corporation 78
that has at least a two-thirds majority of member physicians in 79
active practice and that conducts professional credentialing and 80
quality review activities involving the competence or professional 81
conduct of a health care facility that has contracted with the 82
health insuring corporation to provide health care services to 83
enrollees, which conduct adversely affects, or could adversely 84
affect, the health or welfare of any patient;85

       (g) A peer review committee of a sickness and accident 86
insurer that has at least a two-thirds majority of physicians in 87
active practice and that conducts professional credentialing and 88
quality review activities involving the competence or professional 89
conduct of health care providers that adversely affects or could 90
adversely affect the health or welfare of any patient;91

       (h) A peer review committee of a sickness and accident 92
insurer that has at least a two-thirds majority of physicians in 93
active practice and that conducts professional credentialing and 94
quality review activities involving the competence or professional 95
conduct of a health care facility that has contracted with the 96
insurer to provide health care services to insureds, which conduct 97
adversely affects, or could adversely affect, the health or 98
welfare of any patient;99

       (i) A peer review committee of any insurer authorized under 100
Title XXXIX of the Revised Code to do the business of medical 101
professional liability insurance in this state that conducts 102
professional quality review activities involving the competence or 103
professional conduct of health care providers that adversely 104
affects or could affect the health or welfare of any patient;105

       (j) A peer review committee of the bureau of workers' 106
compensation or the industrial commission that is responsible for 107
reviewing the professional qualifications and the performance of 108
providers conducting medical examinations or file reviews for the 109
bureau or the commission;110

       (k) Any other peer review committee of a health care entity.111

       (F) "Physician" means an individual authorized to practice 112
medicine and surgery, osteopathic medicine and surgery, or 113
podiatric medicine and surgery.114

       (G) "Sickness and accident insurer" means an entity 115
authorized under Title XXXIX of the Revised Code to do the 116
business of sickness and accident insurance in this state.117

       (H) "Tort action" means a civil action for damages for 118
injury, death, or loss to a patient of a health care entity. "Tort 119
action" includes a product liability claim, as defined in section 120
2307.71 of the Revised Code, and an asbestos claim, as defined in 121
section 2307.91 of the Revised Code, but does not include a civil 122
action for a breach of contract or another agreement between 123
persons.124

       (I) "Accountable care organization" means such an 125
organization as defined in 42 C.F.R. 425.20.126

       Sec. 2305.252.  Proceedings and records within the scope of a 127
peer review committee of a health care entity shall be held in 128
confidence and shall not be subject to discovery or introduction 129
in evidence in any civil action against a health care entity or 130
health care provider, including both individuals who provide 131
health care and entities that provide health care, arising out of 132
matters that are the subject of evaluation and review by the peer 133
review committee. No individual who attends a meeting of a peer 134
review committee, serves as a member of a peer review committee, 135
works for or on behalf of a peer review committee, or provides 136
information to a peer review committee shall be permitted or 137
required to testify in any civil action as to any evidence or 138
other matters produced or presented during the proceedings of the 139
peer review committee or as to any finding, recommendation, 140
evaluation, opinion, or other action of the committee or a member 141
thereof. Information142

       Information, documents, or records otherwise available from 143
original sources are not to be construed as being unavailable for 144
discovery or for use in any civil action merely because they were 145
produced or presented during proceedings of a peer review 146
committee, but the information, documents, or records are 147
available only from the original sources and cannot be obtained 148
from the peer review committee's proceedings or records. An149

       The release of any information, documents, or records that 150
were produced or presented during proceedings of a peer review 151
committee or created to document the proceedings does not affect 152
the confidentiality of any other information, documents, or 153
records produced or presented during those proceedings or created 154
to document them. Only the information, documents, or records 155
actually released cease to be privileged under this section.156

        Nothing in this section precludes health care entities from 157
sharing information, documents, or records that were produced or 158
presented during proceedings of a peer review committee or created 159
to document them as long as the information, documents, or records 160
are used only for peer review purposes.161

        An individual who testifies before a peer review committee, 162
serves as a representative of a peer review committee, serves as a 163
member of a peer review committee, works for or on behalf of a 164
peer review committee, or provides information to a peer review 165
committee shall not be prevented from testifying as to matters 166
within the individual's knowledge, but the individual cannot be 167
asked about the individual's testimony before the peer review 168
committee, information the individual provided to the peer review 169
committee, or any opinion the individual formed as a result of the 170
peer review committee's activities. An171

       An order by a court to produce for discovery or for use at 172
trial the proceedings or records described in this section is a 173
final order.174

       Sec. 5164.94.  (A) As used in this section, "telehealth 175
service" means a health care service delivered to a patient 176
through the use of interactive audio, video, or other 177
telecommunications or electronic technology from a site other than 178
the site where the patient is located.179

       (B) The department of medicaid shall establish standards for 180
medicaid payments for health care services the department 181
determines are appropriate to be covered by the medicaid program 182
when provided as telehealth services. The standards shall be 183
established in rules adopted under section 5164.02 of the Revised 184
Code.185

       Section 2. That existing sections 2305.25 and 2305.252 of the 186
Revised Code are hereby repealed.187