Bill Text: IA HF246 | 2019-2020 | 88th General Assembly | Introduced

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Bill Title: A bill for an act establishing the immunization informed consent Act, and providing penalties.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2019-02-06 - Introduced, referred to Human Resources. H.J. 217. [HF246 Detail]

Download: Iowa-2019-HF246-Introduced.html

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House File 246 - Introduced
HOUSE FILE 246
BY SHIPLEY
A BILL FOR
An Act establishing the immunization informed consent Act, and
providing penalties.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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Section 1. NEW SECTION . 135Q.1 Short title.
This chapter shall be known and may be cited as the
“Immunization Informed Consent Protection Act” .
Sec. 2. NEW SECTION . 135Q.2 Definitions.
As used in this chapter, unless the content otherwise
requires:
1. “Department” means the department of public health.
2. “Health care facility” means the same as defined in
section 135C.1.
3. “Health care provider” means a person licensed or
certified by and subject to the authority of a board as defined
in section 147.2 who provides professional health care services
to a patient during that patient’s medical care, treatment, or
confinement.
4. “Hospital” means the same as defined in section 135B.1.
5. “Informed consent” means the right of a patient to
be fully informed about the risks and benefits of a medical
intervention and to make a voluntary decision regarding the
intervention without being coerced, threatened, or punished for
the decision.
6. “Insurer” means an entity providing a plan of health
insurance, health care benefits, or health care services, or
an entity subject to the jurisdiction of the commissioner
of insurance performing utilization review, including an
insurance company offering sickness and accident plans, a
health maintenance organization, a nonprofit health service
corporation, a plan established pursuant to chapter 509A
for public employees, or any other entity providing a plan
of health insurance, health care benefits, or health care
services.
7. “Patient” means a person who has received or is receiving
professional health care services from a health care facility,
health care provider, or hospital.
Sec. 3. NEW SECTION . 135Q.3 Immunizations —— prohibited
discrimination —— civil remedies.
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1. A hospital or health care facility shall not do any of
the following:
a. Discriminate against or terminate the employment or
contract of a health care provider, staff member, employee,
contractor, subcontractor, or applicant for one of these
positions based on the person’s refusal to receive an
immunization.
b. Discriminate against or terminate the employment or
contract of a health care provider, staff member, employee,
contractor or subcontractor based on the person’s willingness
to participate in the immunization of patients.
c. Discriminate against or prohibit or terminate
participation by a volunteer based upon the person’s refusal
to receive an immunization or the person’s willingness to
participate in the immunization of patients.
2. A hospital, health care facility, or educational
institution providing clinical experience to satisfy the
professional degree requirements of a student, intern, or
resident shall not discriminate against the student, intern, or
resident, or prohibit admission, enrollment, or employment as a
student, intern, or resident based on the immunization status
of the student, intern, or resident.
3. A person aggrieved under this section may petition the
district court in the county where the hospital, health care
facility, or educational institution is located for any of the
following, as applicable:
a. Injunctive relief against any further violation.
b. Affirmative relief, including reinstatement of employment
with back pay and interest, or any other equitable relief the
court deems appropriate.
c. Other appropriate relief necessary to ensure compliance
with this section.
Sec. 4. NEW SECTION . 135Q.4 Immunization —— health care
provider licensing authorities.
1. The licensing authority for a health care provider shall
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not deny an applicant for a license or suspend, revoke, or
refuse to renew a license, and shall not take disciplinary
action against a licensee based on the applicant’s or
licensee’s immunization history or refusal to submit to or
administer an immunization.
2. The licensing authority for a health care provider may
deny an applicant a license or suspend, revoke, or refuse to
renew a license, and may take disciplinary action against a
licensee based on the applicant or licensee having three or
more verified failures to comply in one calendar year with the
applicable health care provider requirements pursuant to 42
U.S.C. §300aa-25 and 42 U.S.C. §300aa-26.
Sec. 5. NEW SECTION . 135Q.5 Immunizations —— prohibited
actions —— insurers and insurer ratings —— cease and desist
orders and penalties.
1. An insurer providing a group policy, contract, or plan
for health insurance shall not use the immunization status of
a person as a basis to reject; deny; limit; cancel; refuse to
renew; increase the premiums for; limit the amount, extent, or
kind of coverage available to; or otherwise adversely affect
eligibility or coverage for the group health policy, contract,
or plan for health insurance.
2. An insurer providing a group policy, contract, or plan
for health insurance shall not use the immunization status of a
patient as a qualification or requirement for contracting with
the patient’s provider or as a basis for terminating a contract
with the patient’s provider.
3. The immunization status of a person covered by a group
policy, contract, or plan for health insurance shall not be
used as a factor in the rating of a group policy, contract, or
plan for health insurance in this state.
4. An insurer issuing a group policy, contract, or plan
for health insurance shall not deny a health care facility,
health care provider, or hospital’s participation or decrease
reimbursement based on low patient immunization rates or as the
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H.F. 246
result of a health care facility’s, health care provider’s, or
hospital’s decision not to immunize a patient.
5. An insurer issuing a group policy, contract, or plan for
health insurance who violates this section is subject to the
summary cease and desist order, cease and desist order, and
penalty provisions pursuant to chapter 507B.
Sec. 6. NEW SECTION . 135Q.6 Prohibited activities.
1. A health care facility, health care provider, or hospital
shall not accept an incentive from an insurer or pharmaceutical
company in exchange for the immunization of patients.
2. A health care facility, health care provider, or hospital
shall not require a patient or the parent or guardian of a
patient to sign a liability waiver as a condition of receiving
medical care if the patient or the patient’s parent or guardian
chooses to delay or decline an immunization.
3. The department of human services shall not initiate a
child abuse investigation against the parent or guardian of a
child on the sole basis that the parent or guardian has chosen
to delay or decline an immunization for the child.
4. A health care facility, health care provider, hospital,
or a staff member or employee of a health care facility, health
care provider, or hospital shall not discriminate against a
patient or the parent or guardian of a patient or terminate
treatment of a patient based solely on a patient or a parent
or guardian of a patient choosing to delay or decline an
immunization. The exercise of a patient’s right to informed
consent by delaying or declining immunization shall not be
grounds for the dismissal of a patient from a health care
provider practice, health care facility, or hospital or for a
patient’s loss of medical privileges or benefits.
5. A health care facility, health care provider, or hospital
shall not harass, coerce, admonish, or threaten a patient
or the parent or guardian of a patient for exercising the
patient’s right to delay or decline an immunization.
Sec. 7. NEW SECTION . 135Q.7 Rights of patients.
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1. The department shall publish on the department’s
publicly accessible internet site a summary of the rights of a
patient and the patient’s parent or guardian as specified in
this chapter.
2. If requested, a health care facility, health care
provider, or hospital shall inform a patient and a patient’s
parent or guardian of the address and telephone number of
each state agency responsible for responding to a patient’s
complaints of noncompliance with this chapter.
3. A health care facility, health care provider, or hospital
shall adopt policies and procedures to ensure that a patient
and a patient’s parent or guardian are provided the opportunity
to receive information regarding the patient’s rights under
this chapter.
4. A health care facility, health care provider, or hospital
that fails to make the patient’s summary of rights available to
a patient or the patient’s parent or guardian as specified in
this section shall be subject to the following:
a. (1) For a first unintentional violation, completion of a
corrective action plan.
(2) For a second or subsequent unintentional violation, a
fine of not more than one hundred dollars.
(3) For a first or subsequent intentional violation, a fine
of not more than five hundred dollars, with each intentional
violation constituting a separate violation subject to a
separate fine.
b. In determining the amount of fine to be assessed under
paragraph “a” , the following factors shall be considered:
(1) The scope and severity of the violation, including the
number of patients or parents or guardians of patients found
not to have received notice of a patient’s rights, and whether
the failure to provide the information was willful.
(2) Actions taken by the health care facility, health care
provider, or hospital to correct the violation or to remedy a
complaint.
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(3) Any previous violations under this chapter by a health
care facility, health care provider, or hospital.
Sec. 8. NEW SECTION . 135Q.8 Penalties.
1. A health care facility, health care provider, hospital,
or insurer, as applicable, that violates a provision of this
chapter, is subject to the following as determined by the
appropriate licensing authority:
a. For a first violation, a fine in the amount of one
thousand dollars.
b. For a second or subsequent violation, licensee discipline
as applicable to the health care facility, health care
provider, hospital, or insurer.
2. In addition to the penalties specified in subsection
1, a health care facility, health care provider, hospital,
or insurer, as applicable, that violates this chapter may be
subject to the following, as determined by the department or
the commissioner of insurance, as applicable:
a. A fine of not more than five thousand dollars for an
unintentional violation.
b. A fine of not more than twenty-five thousand dollars
for an intentional violation, with each intentional violation
constituting a separate violation subject to a separate fine.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
This bill creates the “Immunization Informed Consent
Protection Act”. The bill provides definitions used in the
bill.
The bill prohibits a hospital or health care facility
from discriminating against or terminating the employment or
contract of a health care provider, staff member, employee,
contractor, subcontractor, or applicant for one of these
positions based on the person’s refusal to receive an
immunization; and from discriminating against or terminating
the employment or contract of a health care provider, staff
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H.F. 246
member, employee, contractor, or subcontractor based on
the person’s willingness to participate in the immunization
of patients. The bill also prohibits a hospital or health
care facility from discriminating against or prohibiting
or terminating participation by a volunteer based upon the
person’s refusal to receive an immunization or the person’s
willingness to participate in the immunization of patients.
Additionally, a hospital, health care facility, or educational
institution providing clinical experience to satisfy the
professional degree requirements of a student, intern, or
resident is prohibited from discriminating against the student,
intern, or resident, or prohibit admission, enrollment, or
employment as a student, intern, or resident based on the
immunization status of the student, intern, or resident. The
bill provides that a person aggrieved under this portion of
the bill may petition the district court for injunctive relief
against any further violation; affirmative relief, including
reinstatement of employment with back pay and interest; any
other equitable relief the court deems appropriate; or other
appropriate relief necessary to ensure compliance with this
portion of the bill.
With respect to health care provider licensees, the bill
prohibits the licensing authority for a health care provider
from denying an applicant for a license or from suspending,
revoking, or refusing to renew a license, and from taking
disciplinary action against a licensee based on the applicant’s
or licensee’s immunization history or refusal to submit to or
administer an immunization. However, the licensing authority
may deny an applicant a license or suspend, revoke, or refuse
to renew a license, or take disciplinary action against a
licensee based on the applicant or licensee having three or
more verified failures to comply in one calendar year with the
applicable federal health care provider requirements relative
to the recording and reporting of immunization information and
the provision of immunization information to patients under
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federal law.
Relative to insurers and insurance, the bill prohibits an
insurer providing a group policy, contract, or plan for health
insurance from using the immunization status of a person as a
basis to reject; deny; limit; cancel; refuse to renew; increase
the premiums for; limit the amount, extent, or kind of coverage
available to; or otherwise adversely affect eligibility
or coverage for the group health policy, contract, or plan
for health insurance. An insurer providing a group policy,
contract, or plan for health insurance is also prohibited from
using the immunization status of a patient as a qualification
or requirement for contracting with the patient’s provider
or as a basis for terminating a contract with the patient’s
provider. The bill prohibits the immunization status of a
person covered by a group policy, contract, or plan for health
insurance from being used as a factor in the rating of a group
policy, contract, or plan for health insurance in this state,
and prohibits an insurer issuing a group policy contract or
plan for health insurance from denying a health care facility,
health care provider, or hospital’s participation or decreasing
reimbursement based on low patient immunization rates or the
facility’s, provider’s, or hospital’s decision not to immunize
a patient. An insurer who violates this portion of the bill is
subject to the summary cease and desist order, cease and desist
order, and penalty provisions pursuant to Code chapter 507B
(insurance trade practices).
The bill includes other prohibited activities relative to
immunizations. The bill prohibits a health care facility,
health care provider, or hospital from accepting an incentive
from an insurer or pharmaceutical company in exchange for
the immunization of patients; and from requiring a patient
or the parent or guardian of a patient to sign a liability
waiver as a condition of receiving medical care if the patient
or the patient’s parent or guardian chooses to delay or
decline an immunization. The bill prohibits the department
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of human services from initiating a child abuse investigation
against the parent or guardian of a child on the sole basis
that the parent or guardian has chosen to delay or decline
an immunization for the child. Additionally, a health care
facility, health care provider, hospital, or a staff member or
employee of a health care facility, health care provider, or
hospital is prohibited from discriminating against a patient
or the parent or guardian of a patient or from terminating
treatment of a patient based solely on a patient or a parent
or guardian of a patient choosing to delay or decline an
immunization. The exercise of a patient’s right to informed
consent by delaying or declining an immunization shall not
be grounds for the dismissal of a patient from a health care
provider practice, health care facility, or hospital or for a
patient’s loss of medical privileges or benefits. The bill
prohibits a health care facility, health care provider, or
hospital from harassing, coercing, admonishing, or threatening
a patient or the parent or guardian of a patient for exercising
the patient’s right to delay or decline an immunization.
The bill requires the department of public health to
publish on the department’s publicly accessible internet
site a summary of the rights of a patient and the patient’s
parent or guardian as specified in the bill. If requested, a
health care facility, health care provider, or hospital shall
inform a patient and a patient’s parent or guardian of the
address and telephone number of each state agency responsible
for responding to a patient’s complaints of noncompliance
with the provisions of the bill. The bill requires a health
care facility, health care provider, and a hospital to
adopt policies and procedures to ensure that a patient and
a patient’s parent or guardian are provided the opportunity
to receive information regarding the patient’s rights under
the bill. If a health care facility, health care provider,
or hospital fails to make the patient’s summary of rights
available to a patient or the patient’s parent or guardian
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as specified in the bill, the entity is subject to penalties
including a corrective action plan for a first unintentional
violation; a fine of not more than $100 for a second or
subsequent unintentional violation; and a fine of not more
than $500 per violation for a first or subsequent intentional
violation. The bill provides factors to be considered in
determining the amount of fine to be assessed.
The bill includes penalties for a health care facility,
health care provider, hospital, or insurer, as applicable, that
violates a provision of the Code chapter, as determined by the
appropriate licensing authority, including licensing discipline
and fines ranging from $1,000 to $25,000 per violation.
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