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.