HB 497 -- Transparency of Health Care Information and Patient
Safety

Sponsor:  Ervin

This bill establishes requirements for transparency of health
care information and patient safety.

TRANSPARENCY OF HEALTH CARE INFORMATION

Programs of insurers that publicly assess and compare the quality
and cost efficiency of health care providers must conform to
specified criteria for the transparency of health care
information.

Any person who sells or distributes comparative health care
quality and cost-efficiency data for public disclosure must
identify the measuring technique used to validate and analyze the
data, except for articles or research studies published in
peer-reviewed academic journals that do not receive funding from
a health care insurer or state or local government.  Individuals
violating this provision will be investigated by the Department
of Health and Senior Services and may be subject to a penalty of
up to $1,000.  Health insurers violating this provision will be
investigated by the Department of Insurance, Financial
Institutions and Professional Registration and subject to the
department's enforcement powers of the state's insurance laws.

PATIENT SAFETY

Beginning January 1, 2010, hospitals must report all serious
health care incidents resulting in serious adverse events to a
federally designated patient safety organization no later than
one business day following the discovery of the incident.  The
report must describe the immediate actions taken to minimize
patient risk and the prevention measures carried out.  The
hospital will have 45 days after the incident was discovered to
submit a root cause analysis report and prevention plan to the
organization, with or without the technical assistance of the
organization.  If the organization finds any of the reports
provided by the hospital to be insufficient, the hospital will
have two attempts to make corrections.  The Department of Health
and Senior Services will assist hospitals with three or more
insufficient reports and accept reports from a hospital that does
not submit serious adverse events to an organization.  All
hospitals must establish policies to notify a patient within one
business day after the hospital is aware of an occurrence of a
serious adverse event in health care.  Notifying the patient will
not be considered acknowledgment or admission of hospital
liability for the serious adverse event.  After receiving a
complete root cause analysis report and prevention plan from a
hospital, an organization must assess the information and report
back to the hospital its findings and recommendations for
preventing future incidents.

By April 30 of every year, the department must publish to the
public a report indicating the number of serious adverse events
for the previous year by region and category and can include
serious adverse events by type of facility.  Hospitals must
report incidents of serious adverse events on a quarterly basis
to the department.

Patient safety organization meetings with individuals related to
an incident must keep discussions limited to the course of
carrying out the business of the organization.  Proceedings and
records of an organization cannot be used in civil action against
a health care provider, and providers furnishing services to an
organization cannot be liable for civil damages as a result of
findings based on the provider's services.

An organization can disclose non-identifying information
regarding the number and type of patient safety incidents that
occur, but documents and any communication created by a health
care provider must be kept confidential by the organization.

Payment claims for health care services related to a reported
incident of a serious adverse event made by a hospital will not
be subject to the Unfair Claims Settlement Practices Act.
Beginning January 1, 2010, hospitals that report an incident of a
serious adverse event cannot charge for or bill individuals or
insurers for services related to the incident.  If an insurer
denies a claim because of lack of coverage for services that
resulted from an incident of a serious adverse event, the health
care provider or facility involved cannot bill the patient for
the uncovered services.

Missouri House of Representatives
95th General Assembly, 1st Regular Session
Last Updated November 17, 2009 at 9:25 am