04RS HB450


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HB 450 (BR 1106) - R. Wilkey, M. Marzian, J. Adams, J. Barrows, M. Cherry, L. Clark, C. Geveden, J. Gray, C. Hoffman, J. Jenkins, T. McKee, C. Miller, H. Moberly, S. Nunn, D. Pasley, J. Richards, K. Stein, R. Thomas, J. Thompson, J. Wayne, R. Webb, S. Westrom, B. Yonts

     AN ACT relating to medical malpractice and making an appropriation.
     Amend KRS 304.13-051 to require medical malpractice insurers to file rates with the Department of Insurance; authorize the commissioner to hold a hearing on the rate filing; require the insurer to notify policyholders of the proposed rate increase; create a new section of Subtitle 40 of KRS Chapter 304 to require medical malpractice insurers before the first of March 2005 and annually thereafter to file with the commissioner a medical malpractice insurance premium and market statement for the preceding calendar year; create new sections of Subtitle 40 of KRS Chapter 304 to create the Kentucky Health Care Providers' Mutual Insurance Authority to provide medical malpractice insurance to health care providers; provide that the authority is a nonprofit, independent, self-supporting de jure municipal corporation and political subdivision of the Commonwealth; provide for a board of directors which shall function in a manner similar to the governing body of a mutual insurance company; direct the board to hire a manager who shall have proven successful experience for a period of at least five (5) years as an executive at the general management level in insurance operations or in the management of a state fund for medical malpractice; establish powers and duties of the manager; require the authority to provide medical malpractice insurance to any health care provider who pays the premium and complies with any other qualifications and conditions adopted by the authority; require the authority to provide coverage to any health care provider who is unable to secure coverage in the voluntary market unless the provider owes undisputed premiums to a previous medical malpractice carrier or to a medical malpractice residual market mechanism; direct the authority to establish separate rating plans, rates, and underwriting standards for different classes of risks; require rates to be based only on Kentucky experience; authorize the board to declare an annual dividend and distribute it in the form of premium discounts, dividends, or a combination of discounts and dividends if certain conditions are met; require a quarterly report of assets and liabilities to be provided to the board, the Governor, and the Legislative Research Commission; require the board to file an annual report indicating the business done in the previous year and deliver the report to the Governor, commissioner of the Department of Insurance, Auditor of Public Accounts, Attorney General, and co-chairs of the Legislative Research Commission; prohibit the authority from entering into a contract for an audit unless the Auditor of Public Accounts has turned down a request to perform the audit; provide that if the assets of the authority are less than its liabilities, the board may levy an assessment on its policyholders; require the board to formulate and adopt an investment policy; require the manager to compile and maintain statistical and actuarial data; prohibit the authority from receiving any direct state general fund appropriation; authorize the board to initiate a one-time or annual surcharge on all licensed providers; provide that upon request of the board, the Governor and the secretary of the Finance and Administration Cabinet may determine additional initial funding which may include a loan from an existing state agencies not to exceed seven million dollars ($7,000,000); authorize the issuance of revenue bonds not to exceed forty million dollars ($40,000,000) upon approval of the secretary of the Finance and Administration Cabinet; provide that the authority may utilize only agents duly and legally licensed and in good standing with the provisions of this chapter; exempt board members, the manager, and any employee from being held personally liable for acts taken in official capacity; require the board, manager, and employees to comply with the Executive Branch Code of Ethics; prohibit the authority from participating in any plan, pool, association, guarantee, or insolvency fund required by this chapter; require the board to comply with the open meetings and open records laws; direct the Attorney General and the Auditor of Public Accounts to monitor operations of the authority and authorize each to make examinations or investigations of the operations, practices, management, and other matters of the authority; require the Attorney General and the Auditor of Public Accounts to report jointly to the General Assembly in January in each even-numbered year in which the General Assembly convenes in a regular session the results of their monitoring activities; create a new section of KRS Chapter 454 to define "health care provider"; permit either party to request a medical review panel be established; provide that if a panel is requested, proceedings on the malpractice action are stayed during the period of review; provide that the panel shall determine whether the evidence supports the conclusion that the defendant acted or failed to act within the appropriate standards of care as charged in the complaint; provide that the report of the panel is admissible in any action brought by the claimant in a court of law; create a new section of KRS Chapter 454 to require that a lawsuit against a health care provider be submitted to mediation to be held within 90 days after all responsive pleadings are filed; create a new section of KRS Chapter 454 to permit the substitution of the liability insurer as the real party in interest in a claim for medical malpractice or negligence against a health care provider if the plaintiff files a verified acknowledgment that the plaintiff will accept the limits of any available insurance in payment of any settlement or verdict; create new sections of KRS 216B to create a patient safety center within the Cabinet for Health Services to maximize patient safety, reduce medical errors, and improve the quality of health care; require as a condition of licensure that every hospital and ambulatory surgical center report a medical error, adverse medical event, sentinel event, and related patient safety data to the center; amend KRS 311.377 to conform.


     HCS - Retain original provisions; amend KRS 304.13-051 to require medical malpractice insurers who for the 90-day period prior to filing did not issue or renew medical malpractice insurance policies in Kentucky to file rates at least 30 days before the proposed effective date of the rates; delete provision authorizing the Kentucky Health Care Providers' Mutual Insurance Authority board to levy an annual or one-time surcharge on participating health care providers; delete Sections 25 to 32 on medical review panels and replace with new sections of KRS Chapter 411 on medical malpractice screening panels; permit a party to an action for medical malpractice to file a memorandum with the Circuit Court requesting a medical malpractice screening panel be convened; permit a Circuit Court judge to convene a panel if neither party makes a request; provide that if a claim for damages on account of medical malpractice has not been formalized by filing a complaint, any party affected by the claim may request the court to convene a screening panel; provide for a four-member screening panel consisting of a health care provider selected by the plaintiff, a health care provider selected by the defendant, a health care provider selected jointly by plaintiff and defendant, and an attorney who serves as chair selected by the Circuit Court judge; direct state licensing authorities to maintain lists of health care providers available to serve on panels; direct the judge to notify parties that screening panel members are to be appointed within 10 days of the notice; provide that screening panels are to submit written reports within 90 days after the panel is commenced as to whether there was a departure from the standard practice of the health care provider specialty involved and whether a causal relationship existed between the damages suffered by the claimant and any such departure; provide that the written report is admissible in any legal proceeding; provide for screening panel members to be paid a total of $500 and the chair to be paid a total of $1000; require each side to pay 50 percent of the costs of the panel; provide that in those cases before a screening panel which have not been formalized by filing a complaint in a court of law the filing of the request for the panel shall toll any applicable statute of limitations until 30 days after the panel has issued its recommendations; provide that mediation must take place within 180 days after all responsive pleadings are filed unless a screening panel was convened, in which case mediation must take place within 90 days after the filing of the panel's report; delete Section 34 on liability insurer substituted as real party in interest; deleted Sections 35 to 37 on patient safety and replace with new sections of KRS Chapter 216B on patient safety; create a patient health safety center in the Cabinet for Health Services or the Cabinet for Public Health; require as a condition of licensure that every hospital and ambulatory surgical center establish a process for identifying and managing sentinel events; provide that hospitals and ambulatory surgery centers accredited by the Joint Commission on Accreditation of Healthcare Organizations shall be in compliance if they comply with joint commission standards for sentinel events; require the cabinet to analyze the root cause for each sentinel event directly reported to the center and provide evidence-based recommendations to the facility reporting the event; require the cabinet to annually obtain from the joint commission a nonidentifiable report summarizing the number and type of sentinel events and types of root causes reported to it by Kentucky facilities; require every hospital to establish a patient safety program as a condition of licensure; and amend KRS 311.377 to provide that certain information is confidential and cannot be used in a civil action alleging negligent credentialing.

     HFA (1, J. Gooch) - Create a new section of KRS Chapter 141 to tax as income at a rate of 100% the proceeds of punitive damages recovered in a civil action against a health care provider; distribute the funds to aid in funding the Kentucky Access program.

     HFA (2, J. Gooch) - Amend to insert new provision prohibiting an attorney from receiving for services rendered in a medical malpractice case not more than twenty percent of the damages recovered for pain and suffering.

     HFA (3, T. Riner) - Retain original provisions except define "medical error"; require the Patient Safety Center to collect and analyze information on medical errors and unanticipated adverse events; require hospitals to report medical errors and unanticipated adverse events to the Patient Safety Center; and require medical error information to be privileged and confidential.

     HFA (4, T. Riner) - Retain original provisions, except add a new section of KRS Chapter 216B to require the Cabinet for Health Services to collect and disseminate hospital data related to utilization and performance, coordinating its efforts with the national forum for health care quality measurements and reporting; and provide for the correction of factual inaccuracies prior to making the data public.

     HFA (5, R. Wilkey) - Make technical changes.

     HFA (6/Title, R. Wilkey) - Make title amendment.

     Feb 3-introduced in House
     Feb 4-to State Government (H)
     Feb 10-posted in committee
     Feb 17-reported favorably, 1st reading, to Calendar with Committee Substitute
     Feb 18-2nd reading, to Rules; posted for passage in the Regular Orders of the Day for Thursday, February 19, 2004; floor amendments (1) (2) (3) and (4) filed to Committee Substitute
     Feb 19-floor amendment (5) filed to Committee Substitute, floor amendment (6-title) filed
     Feb 20-3rd reading; floor amendment (2) ruled not germane ; floor amendment (3) rejected ; passed 70-19 with Committee Substitute, floor amendments (5) and (6-title)
     Feb 23-received in Senate
     Feb 26-to Banking and Insurance (S)
     Mar 25-taken from committee; 1st reading, to Calendar
     Mar 26-2nd reading; returned to Banking and Insurance (S)

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