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Am. Sub. H. B. No. 123 As Enrolled
(130th General Assembly)
(Amended Substitute House Bill Number 123)
AN ACT
To amend sections 2305.25 and 2305.252 and to enact
section 5164.94 of the Revised Code regarding
health care peer review committee proceedings and
Medicaid coverage of telehealth services.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1. That sections 2305.25 and 2305.252 be amended and
section 5164.94 of the Revised Code be enacted to read as follows:
Sec. 2305.25. As used in this section and sections 2305.251
to 2305.253 of the Revised Code:
(A)(1) "Health care entity" means an entity, whether acting
on its own behalf or on behalf of or in affiliation with other
health care entities, that conducts as part of its regular
business activities professional credentialing or quality review
activities involving the competence of, professional conduct of,
or quality of care provided by health care providers, including
both individuals who provide health care and entities that provide
health care.
(2) "Health care entity" includes any entity described in
division (A)(1) of this section, regardless of whether it is a
government entity; for-profit or nonprofit corporation; limited
liability company; partnership; professional corporation; state or
local society composed of physicians, dentists, optometrists,
psychologists, or pharmacists; or accountable care organization;
other health care organization; or combination of any of the
foregoing entities.
(B) "Health insuring corporation" means an entity that holds
a certificate of authority under Chapter 1751. of the Revised
Code. "Health insuring corporation" includes wholly owned
subsidiaries of a health insuring corporation.
(C) "Hospital" means either any of the following:
(1) An institution that has been registered or licensed by
the department of health as a hospital;
(2) An entity, other than an insurance company authorized to
do business in this state, that owns, controls, or is affiliated
with an institution that has been registered or licensed by the
department of health as a hospital;
(3) A group of hospitals that are owned, sponsored, or
managed by a single entity.
(D) "Incident report or risk management report" means a
report of an incident involving injury or potential injury to a
patient as a result of patient care provided by health care
providers, including both individuals who provide health care and
entities that provide health care, that is prepared by or for the
use of a peer review committee of a health care entity and is
within the scope of the functions of that committee.
(E)(1) "Peer review committee" means a utilization review
committee, quality assessment committee, performance improvement
committee, tissue committee, credentialing committee, or other
committee that does either of the following:
(a) Conducts professional credentialing or quality review
activities involving the competence of, professional conduct of,
or quality of care provided by health care providers, including
both individuals who provide health care and entities that provide
health care;
(b) Conducts any other attendant hearing process initiated as
a result of a peer review committee's recommendations or actions.
(2) "Peer review committee" includes all of the following:
(a) A peer review committee of a hospital or long-term care
facility or a peer review committee of a nonprofit health care
corporation that is a member of the hospital or long-term care
facility or of which the hospital or facility is a member;
(b) A peer review committee of a community mental health
center;
(c) A board or committee of a hospital, a long-term care
facility, or other health care entity when reviewing professional
qualifications or activities of health care providers, including
both individuals who provide health care and entities that provide
health care;
(d) A peer review committee, professional standards review
committee, or arbitration committee of a state or local society
composed of members who are in active practice as physicians,
dentists, optometrists, psychologists, or pharmacists;
(e) A peer review committee of a health insuring corporation
that has at least a two-thirds majority of member physicians in
active practice and that conducts professional credentialing and
quality review activities involving the competence or professional
conduct of health care providers that adversely affects or could
adversely affect the health or welfare of any patient;
(f) A peer review committee of a health insuring corporation
that has at least a two-thirds majority of member physicians in
active practice and that conducts professional credentialing and
quality review activities involving the competence or professional
conduct of a health care facility that has contracted with the
health insuring corporation to provide health care services to
enrollees, which conduct adversely affects, or could adversely
affect, the health or welfare of any patient;
(g) A peer review committee of a sickness and accident
insurer that has at least a two-thirds majority of physicians in
active practice and that conducts professional credentialing and
quality review activities involving the competence or professional
conduct of health care providers that adversely affects or could
adversely affect the health or welfare of any patient;
(h) A peer review committee of a sickness and accident
insurer that has at least a two-thirds majority of physicians in
active practice and that conducts professional credentialing and
quality review activities involving the competence or professional
conduct of a health care facility that has contracted with the
insurer to provide health care services to insureds, which conduct
adversely affects, or could adversely affect, the health or
welfare of any patient;
(i) A peer review committee of any insurer authorized under
Title XXXIX of the Revised Code to do the business of medical
professional liability insurance in this state that conducts
professional quality review activities involving the competence or
professional conduct of health care providers that adversely
affects or could affect the health or welfare of any patient;
(j) A peer review committee of the bureau of workers'
compensation or the industrial commission that is responsible for
reviewing the professional qualifications and the performance of
providers conducting medical examinations or file reviews for the
bureau or the commission;
(k) Any other peer review committee of a health care entity.
(F) "Physician" means an individual authorized to practice
medicine and surgery, osteopathic medicine and surgery, or
podiatric medicine and surgery.
(G) "Sickness and accident insurer" means an entity
authorized under Title XXXIX of the Revised Code to do the
business of sickness and accident insurance in this state.
(H) "Tort action" means a civil action for damages for
injury, death, or loss to a patient of a health care entity. "Tort
action" includes a product liability claim, as defined in section
2307.71 of the Revised Code, and an asbestos claim, as defined in
section 2307.91 of the Revised Code, but does not include a civil
action for a breach of contract or another agreement between
persons.
(I) "Accountable care organization" means such an
organization as defined in 42 C.F.R. 425.20.
Sec. 2305.252. Proceedings and records within the scope of a
peer review committee of a health care entity shall be held in
confidence and shall not be subject to discovery or introduction
in evidence in any civil action against a health care entity or
health care provider, including both individuals who provide
health care and entities that provide health care, arising out of
matters that are the subject of evaluation and review by the peer
review committee. No individual who attends a meeting of a peer
review committee, serves as a member of a peer review committee,
works for or on behalf of a peer review committee, or provides
information to a peer review committee shall be permitted or
required to testify in any civil action as to any evidence or
other matters produced or presented during the proceedings of the
peer review committee or as to any finding, recommendation,
evaluation, opinion, or other action of the committee or a member
thereof. Information
Information, documents, or records otherwise available from
original sources are not to be construed as being unavailable for
discovery or for use in any civil action merely because they were
produced or presented during proceedings of a peer review
committee, but the information, documents, or records are
available only from the original sources and cannot be obtained
from the peer review committee's proceedings or records. An
The release of any information, documents, or records that
were produced or presented during proceedings of a peer review
committee or created to document the proceedings does not affect
the confidentiality of any other information, documents, or
records produced or presented during those proceedings or created
to document them. Only the information, documents, or records
actually released cease to be privileged under this section.
Nothing in this section precludes health care entities from
sharing information, documents, or records that were produced or
presented during proceedings of a peer review committee or created
to document them as long as the information, documents, or records
are used only for peer review purposes.
An individual who testifies before a peer review committee,
serves as a representative of a peer review committee, serves as a
member of a peer review committee, works for or on behalf of a
peer review committee, or provides information to a peer review
committee shall not be prevented from testifying as to matters
within the individual's knowledge, but the individual cannot be
asked about the individual's testimony before the peer review
committee, information the individual provided to the peer review
committee, or any opinion the individual formed as a result of the
peer review committee's activities. An
An order by a court to produce for discovery or for use at
trial the proceedings or records described in this section is a
final order.
Sec. 5164.94. (A) As used in this section, "telehealth
service" means a health care service delivered to a patient
through the use of interactive audio, video, or other
telecommunications or electronic technology from a site other than
the site where the patient is located.
(B) The department of medicaid shall establish standards for
medicaid payments for health care services the department
determines are appropriate to be covered by the medicaid program
when provided as telehealth services. The standards shall be
established in rules adopted under section 5164.02 of the Revised
Code.
SECTION 2. That existing sections 2305.25 and 2305.252 of the
Revised Code are hereby repealed.
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