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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| HOUSE BILL |
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| INTRODUCED BY MUNDY, PASHINSKI, CUTLER, DeLUCA, FABRIZIO, FREEMAN, KORTZ, MURPHY, PAYTON, STABACK AND WAGNER, JANUARY 26, 2011 |
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| REFERRED TO COMMITTEE ON HEALTH, JANUARY 26, 2011 |
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| AN ACT |
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1 | Providing for quality health care management system discount; |
2 | imposing duties on the Department of Health; and providing |
3 | for penalties. |
4 | The General Assembly of the Commonwealth of Pennsylvania |
5 | hereby enacts as follows: |
6 | Section 1. Short title. |
7 | This act shall be known and may be cited as the Quality |
8 | Management in Health Care Act. |
9 | Section 2. Findings and declarations. |
10 | The General Assembly finds and declares as follows: |
11 | (1) It is the purpose of this act to ensure that quality |
12 | medical care is available to all citizens of this |
13 | Commonwealth through a comprehensive and high-quality health |
14 | care system. |
15 | (2) To maintain and improve this system, medical |
16 | professional liability insurance has to be obtainable at an |
17 | affordable and reasonable cost throughout this Commonwealth. |
18 | (3) Every effort must be made to reduce and eliminate |
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1 | medical errors by identifying problems and implementing |
2 | solutions that promote patient safety. |
3 | (4) Recognition and furtherance of these elements is |
4 | essential to the health, safety and welfare of the citizens |
5 | of Pennsylvania. |
6 | (5) The costs of medical malpractice insurance premiums |
7 | are directly impacted by medical errors. |
8 | (6) Research shows a vast majority of medical errors are |
9 | systemic rather than human errors. |
10 | (7) Quality management systems implemented in the health |
11 | care industry and by the United States Department of Veterans |
12 | Affairs hospital system have reduced medical errors. |
13 | (8) It is a further purpose of this act to improve |
14 | patient safety, improve health care quality and lower health |
15 | care costs by offering a reduction in medical malpractice |
16 | costs to health care providers that institute quality |
17 | management systems into health care. |
18 | Section 3. Definitions. |
19 | The following words and phrases when used in this act shall |
20 | have the meanings given to them in this section unless the |
21 | context clearly indicates otherwise: |
22 | "Assessment." The assessment imposed under section 712 of |
23 | the act of March 20, 2002 (P.L.154, No.13), known as the Medical |
24 | Care Availability and Reduction of Error (Mcare) Act. |
25 | "Department." The Department of Health of the Commonwealth. |
26 | "Health care provider." A primary health care center or a |
27 | person which contributes to and participates in the Medical Care |
28 | Availability and Reduction of Error Fund established under |
29 | section 712 of the act of March 20, 2002 (P.L.154, No.13), known |
30 | as the Medical Care Availability and Reduction of Error (Mcare) |
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1 | Act, including a corporation, university or other educational |
2 | institution licensed or approved by the Commonwealth to provide |
3 | health care or professional medical services as a physician, a |
4 | certified nurse midwife, a podiatrist, hospital, nursing home, |
5 | birth center and an officer, employee or agent thereof acting in |
6 | the course and scope of their employment. |
7 | "Quality health care management system." A health care |
8 | management system which is industrywide, systematic, sustainable |
9 | and centered on the quality of the system's operations and |
10 | outcomes. The term includes participation and accountability of |
11 | its members and an assurance of the availability of resources |
12 | and information needed to operate as planned, smoothly |
13 | integrated processes and systems, clear communications and |
14 | ongoing monitoring, measurement, feedback and corrective or |
15 | preventive actions to ensure the system produces intended |
16 | results. |
17 | Section 4. Quality health care management system discount. |
18 | A health care provider which implements a quality health care |
19 | management system to the satisfaction and approval of the |
20 | department shall be entitled to a 20% discount of the health |
21 | care provider's assessment for each year the total quality |
22 | health care management system is implemented and utilized. The |
23 | discount shall apply to the assessment paid by a health care |
24 | provider on behalf of other health care providers participating |
25 | in the quality management system. |
26 | Section 5. Department. |
27 | (a) Quality management health care system approval.-- |
28 | (1) A quality management health care system may apply to |
29 | the department for approval. The application shall be on a |
30 | form prescribed by the department and shall be accompanied by |
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1 | a fee set by regulation. |
2 | (2) Within 30 days of receipt of an application under |
3 | paragraph (1), the department shall: |
4 | (i) if the department determines the system will |
5 | successfully reduce medical errors by a health care |
6 | provider, approve the application; or |
7 | (ii) if the department determines the system will |
8 | not successfully reduce medical errors by a health care |
9 | provider, deny the application. This subparagraph is |
10 | subject to 2 Pa.C.S. Ch. 7 Subch. A (relating to judicial |
11 | review of Commonwealth agency action). |
12 | (3) If the department fails to act within the time |
13 | specified in paragraph (2), the application shall be deemed |
14 | approved. |
15 | (b) Quality management health care system implementation.-- |
16 | The department shall provide health care providers with a |
17 | certification of implementation of total quality management |
18 | health care systems once the provider's application is approved |
19 | under this section. Health care providers shall provide the |
20 | certification to the Insurance Department in order to claim the |
21 | discount provided for under section 4. |
22 | (c) Regulations.--The department and the Insurance |
23 | Department may promulgate regulations to implement this act. |
24 | (d) Report.--On or before January 1, 2012, and each year |
25 | thereafter, the department and the Insurance Department shall |
26 | jointly provide a report on the effectiveness of this act. The |
27 | report shall include: |
28 | (1) The name and number of total quality management |
29 | systems approved by the department. |
30 | (2) The name and number of quality management systems |
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1 | disapproved by the department. |
2 | (3) The name and number of health care providers who |
3 | have received the discount. |
4 | (4) The total estimated savings to the health care |
5 | system. |
6 | Section 6. Penalties and remedies. |
7 | (a) Penalties and remedies.--Upon a determination by hearing |
8 | this act was violated, the Secretary of Health may pursue one or |
9 | more of the following courses of action: |
10 | (1) Issue an order requiring the person in violation to |
11 | cease and desist from engaging in the violation. |
12 | (2) Suspend or revoke or refuse to issue or renew the |
13 | certificate or license of the person in violation. |
14 | (3) Impose a civil penalty of not more than $50,000 for |
15 | each violation. |
16 | (4) Impose another appropriate remedy. |
17 | (b) Other remedies.--The enforcement remedies imposed under |
18 | this section are in addition to other remedies or penalties that |
19 | may be imposed by another applicable statute. |
20 | Section 20. Effective date. |
21 | This act shall take effect in 60 days. |
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