HB 490 (BR 979) - R. Wilkey
AN ACT relating to health care providers.
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; 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 2006 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 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; 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 agency not to exceed $7,000,000; authorize the issuance of revenue bonds not to exceed $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; 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 a plan, pool, association, guarantee, or insolvency fund; 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 new sections of KRS Chapter 411 to establish medical malpractice screening panels; permit a party to an action for medical malpractice to file a memorandum with the Circuit Court requesting that 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 $1,000; 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; 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 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; allow parties to consent to a postponement of up to 60 days; permit parties to opt out of mediation only by obtaining a court order; permit parties to mutually agree to select a mediator; direct court to appoint mediator if parties cannot agree within 20 days after all responsive pleadings are filed; require parties to provide mediator with a statement of issues at least 7 days prior to mediation; authorize mediator to cancel mediation if all parties do not submit statement of issues or any party fails to attend within the first 30 minutes of the session; authorize those persons present at the session to settle the case for an amount deemed appropriate by the party or parties they represent; direct the parties to extend authority to settle to their insurers where consent to settle is required by the policy of insurance; provide that if a settlement is reached the parties must file notice with the court within 10 days; require the mediator to file a report with the court on the outcome of mediation; require the parties to pay the mediator's fee equally; create new sections of KRS 216B to create a patient safety center within the Cabinet for Health Services of 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 are in compliance if they meet 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; amend KRS 311.377 to provide that certain information is confidential and cannot be used in a civil action alleging negligent credentialing.
Feb 14-introduced in House
Feb 15-to Judiciary (H)